NPI 1003469867

Kyle Allan Vance

Practitioner Physician Assistant South Jordan, UT

Practice location

Address: 10433 S Redwood Rd STE B, South Jordan, UT 84095-8502
Phone: (801) 260-1919
Mailing address: PO Box 95590, South Jordan, UT 84095-0590

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 11353630-1206 (UT)

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Registry record

NPI: 1003469867
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jul 2019
Record last updated: 22 Jul 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.