Individual
TRACEY F RADOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2015 SIDEWINDER DR, PARK CITY, UT 84060-7323
(435) 645-9095
(435) 645-9092
Mailing address
2266 DOC HOLIDAY DR, PARK CITY, UT 84060-7428
(602) 617-3742
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8244561-2401
UT
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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