Individual
KEVIN JAMES CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 E HUNTERS HVN, SARATOGA SPRINGS, UT 84045-8169
(801) 400-9616
Mailing address
30 E HUNTERS HVN, SARATOGA SPRINGS, UT 84045-8169
(801) 400-9616
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10620174-1206
UT
Other
Enumeration date
01/03/2018
Last updated
01/03/2018
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