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Individual

STACI LEE GUNTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-6908
Mailing address
2120 S HIGHLAND DR APT 530, SALT LAKE CITY, UT 84106-3376
(801) 787-4827

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10560992-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
10560992-1206
UT

Other

Enumeration date
11/13/2017
Last updated
12/08/2017
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