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1417610890
ELIZABETH MAHONEY
PROVO, UT
NPI
1417610890
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 12474207-1206)
Enumeration Date
2021-10-21
Last Update Date
2022-01-31
Business Address
ELIZABETH MAHONEY PA
1055 N 500 W # 205
PROVO, UT 84604-3305
Phone number: 801-429-8095
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Mailing Address
ELIZABETH MAHONEY PA
1055 N 500 W ATTN CREDENTIALING
PROVO, UT 84604
Phone number: 801-354-8225
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