Individual
DESTINY ASTIN MANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3959 STADIUM WAY DEPT 3913, OGDEN, UT 84408-0001
(801) 921-3289
Mailing address
3959 STADIUM WAY DEPT 3913, OGDEN, UT 84408-0001
(801) 921-3289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
UT
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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