Individual
MS. HEATHER RAE VAN LOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1950 CIRCLE OF HOPE, HCH 4TH FLOOR, SLC, UT 84112-5550
(801) 585-0100
(801) 585-2935
Mailing address
127 S 500 E STE 600, SLC, UT 84102-1971
(801) 587-6705
(801) 715-8228
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8372563-1206
UT
363AM0700X
Medical Physician Assistant
8372563-1206
UT
Other
Enumeration date
08/03/2012
Last updated
05/02/2023
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