Individual
AMBER ASTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
782 CANTERBURY LN, ALPINE, UT 84004-1255
(801) 866-8802
Mailing address
782 CANTERBURY LN, ALPINE, UT 84004-1255
(801) 866-8802
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11940162-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/03/2020
Last updated
09/23/2020
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