Individual
DEREK OMORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3723 W 12600 S STE 450, RIVERTON, UT 84065-7296
(801) 285-4673
Mailing address
3723 W 12600 S STE 450, RIVERTON, UT 84065-7296
(801) 285-4673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/12/2015
Last updated
12/24/2023
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