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Individual

MS. SALLY JOYE DESONIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
370 9TH AVE, SUITE #106, SALT LAKE CITY, UT 84103-2877
(801) 408-5700
(801) 408-5700
Mailing address
1504 S 1800 E, SALT LAKE CITY, UT 84108-2652
(801) 474-9495

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
282418-1206
UT

Other

Enumeration date
05/08/2007
Last updated
07/08/2007
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