Individual
LISA MARIE STUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1900 N STATE ST, PROVO, UT 84604-1305
(801) 373-2001
(801) 373-4748
Mailing address
1900 N STATE ST, PROVO, UT 84604-1305
(801) 373-2001
(801) 373-4748
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6291261-1206
UT
Other
Enumeration date
04/16/2008
Last updated
10/02/2018
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