Individual
LESLIE MADORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9720 SOUTH 1300 EAST, SUITE E230, SANDY, UT 84094
(801) 501-2950
(801) 501-2951
Mailing address
9720 S 1300 E, SUITE E230, SANDY, UT 84094-3712
(801) 501-2950
(801) 501-2951
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9377430-1206
UT
Other
Enumeration date
02/14/2006
Last updated
01/22/2016
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