Individual
TERI JUNKO DEMILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPH, MSHS
Contact information
Practice address
2084 N ROBINS DR STE A, LAYTON, UT 84041-1118
(801) 773-8644
Mailing address
2084 N ROBINS DR STE A, LAYTON, UT 84041-1118
(801) 773-8644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005486
VA
363A00000X
Physician Assistant
Primary
10071253-1206
UT
Other
Enumeration date
05/16/2017
Last updated
06/12/2020
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