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SOUTSADA KONESAVANH, PA-C
PA-C
Medical Physician Assistant
NPI: 1417108606IndividualAccepts Medicare
Specialties, Licenses & Credentials
Physician Assistant
Physician Assistant
Code: 363A00000X
7138480-1206(UT)
Medical Physician AssistantPrimary
Physician Assistant — Medical
Code: 363AM0700X
7138480-1206(UT)
CMS Specialties
PrimaryPHYSICIAN ASSISTANT
Education
OTHER
Class of 2008
Contact & Hours
- Address
- 100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112 - Phone
- (801) 585-2341
Quick Facts
- NPI
- 1417108606
- Entity Type
- Individual
- Gender
- Female
- Medicare
- Accepted
- Specialties
- 2
- Locations
- 1
- Years in Practice
- 18
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