Individual
MITCHELL T SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1350 E 750 N, SUITE 1, OREM, UT 84097-4345
(801) 850-4250
Mailing address
1350 E 750 N, SUITE 1, OREM, UT 84097-4345
(801) 850-4250
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5339107-1206
UT
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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