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General NPI Number Information
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NPI Number | 1619909017
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Entity Type | Individual
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Provider Name | SHIRLEY L. ALA PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 791 TURNER ST UNIT 2
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City | AUBURN
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State | ME
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Zip | 04210-6314
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Country | US
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Telephone | 207-330-3900
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Fax | 207-330-3940
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Provider Business Mailing Address
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Address Line | 2295 FOOTHILL DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-4000
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Country | US
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Telephone | 801-486-3021
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Fax | 801-485-6339
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2166771206
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License Number State | UT
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