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1366160921
SYDNEY FONTAINE
SALT LAKE CITY, UT
NPI
1366160921
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 12919118-1206)
Enumeration Date
2022-08-19
Last Update Date
2022-12-03
Business Address
SYDNEY FONTAINE
30 N 1900 E # 3B400
SALT LAKE CITY, UT 84132-0002
Phone number: 801-581-7719
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Mailing Address
SYDNEY FONTAINE
30 N 1900 E # 3B400
SALT LAKE CITY, UT 84132-0002
Phone number:
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