Coulson Dirk Boggess

NPI #1215829775 in Salem, Utah

Provider Information

NPI Number: 1215829775
Entity Type: Individual
Name: Coulson Dirk Boggess
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Jul 18, 2025
Last Updated: Jul 18, 2025

Practice Location

Address: 449 E 960 S
City: Salem
State: Utah
ZIP Code: 84653-4606
Phone: (801) 609-8641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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