Individual
KATHERINE MARIE HADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
527 W 400 N, OREM, UT 84057-1916
(801) 714-3570
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(866) 415-6556
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
80464531206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80464531206
LICENSE
UT
01
—
PA2018-0052
LICENSE
NM
Enumeration date
08/22/2011
Last updated
11/11/2025
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