Individual
COURTNEY WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
557 W 2600 S, BOUNTIFUL, UT 84010-7717
(801) 298-9155
(801) 298-9156
Mailing address
557 W 2600 S, BOUNTIFUL, UT 84010-7717
(801) 298-9155
(801) 298-9156
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12615135-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/17/2020
Last updated
01/21/2022
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