Individual
SIMONE MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7070
Mailing address
1975 S 1100 E, APT. 4, SALT LAKE CITY, UT 84106-2329
(805) 235-2550
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
98199012401
UT
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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