Individual
LESLIE A. FABIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7086
Mailing address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7973880-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200106810A
—
OK
Enumeration date
03/22/2007
Last updated
06/27/2022
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