Individual
LIESL HADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-S
Contact information
Practice address
3556 W 9800 S STE 101, SOUTH JORDAN, UT 84095-3221
(801) 567-9780
Mailing address
PO BOX 100253, ATLANTA, GA 30384-0253
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14245330-1205
UT
363AS0400X
Surgical Physician Assistant
14245330-1206
UT
Other
Enumeration date
05/09/2024
Last updated
04/23/2026
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