Organization
STEVENSON ORTHOPEDIC SERVICES P.LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP EUGENE STEVENSON PA-C (ORGANIZER)
(208) 936-0303
Entity
Organization
Contact information
Practice address
4401 COLLEGE DR, ROCK SPRINGS, WY 82901-3507
(307) 352-8930
(307) 352-8947
Mailing address
3714 N 2455 E, TWIN FALLS, ID 83301-5791
(208) 936-0303
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PT764
WY
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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