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1568700375
KENT MA
DRAPER, UT
NPI
1568700375
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 85122911206)
Enumeration Date
2013-01-29
Last Update Date
2013-01-29
Business Address
-- KENT MA PA
233 W BEVERLEE ANN DR
DRAPER, UT 84020-6875
Phone number: 801-550-8895
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Mailing Address
-- KENT MA PA
233 W BEVERLEE ANN DR
DRAPER, UT 84020-6875
Phone number: 801-550-8895
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