Individual
MARK POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 E 3900 S, SALT LAKE CITY, UT 84124-1300
(801) 268-7111
Mailing address
1312 E 3730 S, SALT LAKE CITY, UT 84106-2937
(801) 604-8747
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10279444-4201
UT
Other
Enumeration date
07/05/2017
Last updated
07/05/2017
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