Tiffany Park, PA-C

NPI #1902458268 in Salt Lake City, Utah

Provider Information

NPI Number: 1902458268
Entity Type: Individual
Name: Tiffany Park, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 16, 2019
Last Updated: Dec 7, 2020

Practice Location

Address: 375 S CHIPETA WAY
City: Salt Lake City
State: Utah
ZIP Code: 84108-1260
Phone: (801) 446-3038

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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