Individual
LAUREN ANN MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2000 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5550
(801) 585-0100
Mailing address
3206 SUNSET HOLLOW DR, BOUNTIFUL, UT 84010-3213
(801) 633-8695
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9146360-1206
UT
363AM0700X
Medical Physician Assistant
9146360-8906
UT
Other
Enumeration date
09/17/2014
Last updated
11/08/2021
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