Individual
KENT MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
233 W BEVERLEE ANN DR, DRAPER, UT 84020-6875
(801) 550-8895
Mailing address
233 W BEVERLEE ANN DR, DRAPER, UT 84020-6875
(801) 550-8895
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85122911206
UT
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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