Individual
MISS MARK WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5848 S FASHION BLVD, MURRAY, UT 84107-6157
(801) 314-8300
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11107589-1206
UT
Other
Enumeration date
08/03/2018
Last updated
06/27/2019
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