Individual
BENJAMIN JOHN RICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3451 S 5600 W, SUITE F, WVC, UT 84020
(801) 957-0900
(801) 966-4984
Mailing address
10433 S REDWOOD RD STE 2, SOUTH JORDAN, UT 84095-8502
(801) 260-1919
(801) 260-1441
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7510295-1206
UT
363AM0700X
Medical Physician Assistant
7510295-1206
UT
363AS0400X
Surgical Physician Assistant
7510295-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7510295-1206
UTAH PA LICENSE
UT
Enumeration date
09/18/2018
Last updated
03/20/2025
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