Individual
TYLER JORDAN MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1741 N 2000 W STE 3, FARR WEST, UT 84404-9811
(801) 917-6177
(801) 917-5688
Mailing address
1741 N 2000 W STE 3, FARR WEST, UT 84404-9811
(801) 917-6177
(801) 917-5688
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10097081-1206
UT
Other
Enumeration date
05/11/2016
Last updated
05/01/2025
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