Individual
COLLIN KENNETH SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
50 N MEDICAL DR, 2R110A SOM, SALT LAKE CITY, UT 84132-0001
(801) 585-0297
Mailing address
937 E 6795 S, MIDVALE, UT 84047-5038
(618) 444-1498
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7447176-2401
UT
Other
Enumeration date
09/10/2009
Last updated
11/08/2021
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