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Individual

STEPHANIE BOULTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1265 E FORT UNION BLVD STE 120, COTTONWOOD HEIGHTS, UT 84047-1845
(801) 917-5561
(800) 775-1064
Mailing address
8132 S 3500 E, COTTONWOOD HEIGHTS, UT 84121-5956
(801) 995-1235
(800) 775-1064

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
12/16/2008
Last updated
08/12/2025
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