Individual
WILLIAM WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-5311
Mailing address
PO BOX 58049, SALT LAKE CITY, UT 84158-0049
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103953-1206
UT
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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