Individual
MRS. HAILEY POPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
390 N MAIN ST, BOUNTIFUL, UT 84010-6046
(801) 294-1000
Mailing address
390 N MAIN ST, BOUNTIFUL, UT 84010-6046
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9166581-1206
UT
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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