Individual
BENJAMIN T DEDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1580 W ANTELOPE DR STE 110, LAYTON, UT 84041-1153
(801) 807-7699
Mailing address
1489 S HIGLEY RD STE 101, GILBERT, AZ 85296-4777
(480) 457-8800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6854
AZ
363A00000X
Physician Assistant
Primary
10982649-1206
UT
Other
Enumeration date
09/29/2017
Last updated
07/21/2022
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