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Individual

NICHOLAS S DEMILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
617 E RIVERSIDE DR STE 301, ST GEORGE, UT 84790-8722
(435) 216-7000
(435) 216-7001
Mailing address
617 E RIVERSIDE DR STE 301, ST GEORGE, UT 84790-8722
(435) 216-7000
(435) 216-7001

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11214124-1206
UT
363AM0700X
Medical Physician Assistant
Primary
11522934-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/27/2021
Last updated
03/29/2023
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