Individual
KYLE DAVID WILKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7109
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6384251-1206
UT
363AS0400X
Surgical Physician Assistant
6384251-1206
UT
Other
Enumeration date
03/20/2008
Last updated
02/19/2024
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