Individual
MARK STOUT MCOMBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
331 N 400 W, OREM, UT 84057-1913
(801) 224-4080
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
119128-2401
UT
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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