Individual
KENT B WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
550 E 1400 N, SUITE R, LOGAN, UT 84341-2406
(435) 755-9484
(435) 755-2832
Mailing address
550 E 1400 N, STE R, LOGAN, UT 84341-2406
(435) 755-9484
(435) 755-2832
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
105103-1206
UT
Other
Enumeration date
11/07/2005
Last updated
05/15/2008
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