Individual
KELSY ANN BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4403 HARRISON BLVD, SUITE 3815, OGDEN, UT 84403-3271
(801) 387-3400
(801) 475-1621
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-3400
(801) 475-1621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5722982-1206
UT
Other
Enumeration date
09/08/2011
Last updated
09/07/2012
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