Individual
CAMILLE KOGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3903 HARRISON BLVD, SUITE 400, OGDEN, UT 84403-2314
(801) 387-2080
Mailing address
3903 HARRISON BLVD, SUITE 400, OGDEN, UT 84403-2314
(801) 387-2080
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10196066-2402
UT
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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