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Individual

AMANDA L DICKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPAS, PA-C

Contact information

Practice address
555 N STARCREST DR APT B33, SALT LAKE CITY, UT 84116-2485
(801) 867-6525
Mailing address
3665 S 8400 W STE 101, MAGNA, UT 84044-4907
(801) 250-9638

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12118651-1206
UT
363AM0700X
Medical Physician Assistant
12118651-1206
UT

Other

Enumeration date
07/16/2019
Last updated
08/28/2022
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