Individual
STEPHANIE OSBORN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1900 N STATE ST, PROVO, UT 84604-1305
(801) 373-2001
Mailing address
1900 N STATE ST, PROVO, UT 84604-1305
(801) 373-2001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
020585061
UT
Other
Enumeration date
09/05/2017
Last updated
07/21/2022
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