Individual
MISS STEPHANIE CALLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2733
Mailing address
PO BOX 510721, SALT LAKE CITY, UT 84151-0721
(801) 581-2733
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
68423404002
UT
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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