Individual
TARA LEE DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
300 W 1400 S, GARLAND, UT 84312-9393
(435) 257-2469
(435) 257-2434
Mailing address
300 W 1400 S, GARLAND, UT 84312-9393
(435) 257-2469
(435) 257-2434
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
51994251206
UT
Other
Enumeration date
09/21/2005
Last updated
11/28/2007
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