Individual
HEATHER BENALLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1912 W 930 N, PLEASANT GROVE, UT 84062-4104
(801) 492-1999
(801) 492-1991
Mailing address
767 E 750 N, AMERICAN FORK, UT 84003-1584
(801) 492-1999
(801) 492-1991
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5655758-1206
UT
Other
Enumeration date
05/26/2006
Last updated
07/08/2007
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