Individual
DALLIN RICHARD KILPACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
537 W 500 S, MANTI, UT 84642-5508
(385) 296-8427
Mailing address
537 W 500 S, MANTI, UT 84642-5508
(385) 296-8427
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9114166-4405
UT
Other
Enumeration date
12/21/2021
Last updated
12/21/2021
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