Individual
MARIE DUFRESNE BAMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1685 W 2200 S, SALT LAKE CITY, UT 84119-1456
(801) 887-5455
Mailing address
893 13TH AVE, SALT LAKE CITY, UT 84103-3328
(801) 596-8631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
117517-2401
UT
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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