Individual
CAMI JO WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3943 E PONY EXPRESS PKWY STE 120, EAGLE MOUNTAIN, UT 84005-5543
(801) 789-5566
Mailing address
3943 E PONY EXPRESS PKWY STE 120, EAGLE MOUNTAIN, UT 84005-5543
(801) 789-5566
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9895827-1206
UT
363AM0700X
Medical Physician Assistant
9895827-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497099105
—
UT
Enumeration date
11/19/2012
Last updated
07/10/2020
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