Individual
ASHLY JANE PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
75 E 12300 S STE 100, DRAPER, UT 84020-8073
(801) 422-4636
Mailing address
75 E 12300 S STE 100, DRAPER, UT 84020-8073
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
12929506-4810
UT
363A00000X
Physician Assistant
Primary
12929506-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12929506-4810
PRIVATE INSURANCE
UT
Enumeration date
08/11/2022
Last updated
06/15/2026
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