Individual
HALEY MICHELLE VANDERHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-1272
Mailing address
30 N ORANGE ST UNIT A316, SALT LAKE CITY, UT 84116-3938
(414) 617-3807
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
WI
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
02/08/2017
Last updated
12/20/2021
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