Individual
LORI C HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1373 E CASSITY DR, TOOELE, UT 84074-4107
(907) 947-6765
Mailing address
1373 E CASSITY DR, TOOELE, UT 84074-4107
(907) 947-6765
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10332057-1206
UT
363A00000X
Physician Assistant
PA1659
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10332057-1206
LICENSE
UT
05
—
1603011
—
AK
05
—
1912338872
—
NV
Enumeration date
12/03/2013
Last updated
10/22/2024
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