Individual
TERAN MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9450 S 1300 E, SANDY, UT 84094-5555
(801) 501-6333
Mailing address
2203 E GLACIER VIEW DR, SANDY, UT 84092-5604
(801) 214-5048
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8020165-1206
UT
363A00000X
Physician Assistant
8020165-8906
UT
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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