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1326738055
MADISON MICHELLE POWELSON
PROVO, UT
NPI
1326738055
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 14175034-1206)
Enumeration Date
2023-05-08
Last Update Date
2024-09-10
Business Address
MADISON MICHELLE POWELSON
395 W COUGAR BLVD STE 704
PROVO, UT 84604-3333
Phone number: 801-357-3242
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Mailing Address
MADISON MICHELLE POWELSON
1219 N BAYCREST DR
SARATOGA SPRINGS, UT 84045-5004
Phone number: 801-362-1649
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