Individual
DERRYK ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1100 S MEDICAL DR, MT PLEASANT, UT 84647-2222
(435) 462-3471
Mailing address
1100 S MEDICAL DR, MT PLEASANT, UT 84647-2222
(435) 462-3471
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5472057-1206
UT
363AM0700X
Medical Physician Assistant
5472057-1206
UT
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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