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1487635579
KENT B WHITAKER
LOGAN, UT
NPI
1487635579
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 105103-1206)
Enumeration Date
2005-11-07
Last Update Date
2008-05-15
Business Address
-- KENT B WHITAKER PA
550 E 1400 N SUITE R
LOGAN, UT 84341-2406
Phone number: 435-755-9484
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Mailing Address
-- KENT B WHITAKER PA
550 E 1400 N STE R
LOGAN, UT 84341-2406
Phone number: 435-755-9484
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