Individual
MRS. STEPHANIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
1551 RENAISSANCE TOWNE DR STE 350, BOUNTIFUL, UT 84010-7674
(801) 295-3553
(801) 295-3599
Mailing address
1551 RENAISSANCE TOWNE DR STE 350, BOUNTIFUL, UT 84010-7674
(801) 295-3553
(801) 295-3599
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11791605-2401
UT
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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