Individual
DANETTE STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
698 12TH ST, OGDEN, UT 84404-6200
(801) 354-8225
(801) 418-0941
Mailing address
1055 N 500 W, STE 260, PROVO, UT 84604-3305
(801) 375-8858
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102410-1206
UT
Other
Enumeration date
04/06/2006
Last updated
09/07/2012
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