Individual
TANDY MUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4460 S HIGHLAND DR STE 400, SALT LAKE CITY, UT 84124-3565
(801) 272-4111
(801) 272-5989
Mailing address
4460 S HIGHLAND DR STE 400, SALT LAKE CITY, UT 84124-3565
(801) 272-4111
(801) 272-5989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11281903-1206
UT
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
04/30/2019
Last updated
09/30/2020
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