Provider First Line Business Practice Location Address:
DIVISION OF PHYSICIAN ASSISTANT EDUCATION AND SCIENCES
Provider Second Line Business Practice Location Address:
C/O: MATT WALDROP 295 CHIPETA WAY, SUITE 22
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-351-0588
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2026