Individual
MR. BRADLEY ORIN STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5848 S FASHION BLVD STE 110, SALT LAKE CITY, UT 84107-6175
(801) 314-4005
(801) 314-4015
Mailing address
5848 S FASHION BLVD STE 110, SALT LAKE CITY, UT 84107-6175
(801) 314-4005
(801) 314-4015
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
7731542-1206
UT
Other
Enumeration date
02/10/2017
Last updated
10/16/2017
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