Provider Demographics
NPI:1710542949
Name:CLUFF, LESLIE C (DMSC, PA-C)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:C
Last Name:CLUFF
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Gender:F
Credentials:DMSC, PA-C
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Mailing Address - Street 1:81 N MARIO CAPECCHI DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84113-1125
Mailing Address - Country:US
Mailing Address - Phone:801-213-3599
Mailing Address - Fax:801-587-7539
Practice Address - Street 1:2250 N MILLER CAMPUS DR
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-7233
Practice Address - Country:US
Practice Address - Phone:801-213-3599
Practice Address - Fax:801-587-7539
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT9886636-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant