Individual
MR. MARK THAIN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17800 CAMP WILLIAMS RD, BLDG 9000 SUITE 200, RIVERTON, UT 84065-4905
(801) 523-4406
Mailing address
242 W 6TH AVE, MIDVALE, UT 84047-7380
(081) 352-2303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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