Individual
ANA CORINA BANCILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, CKTP
Contact information
Practice address
12702 S FORT ST, DRAPER, UT 84020-9755
(801) 571-2704
Mailing address
4571 S WOODDUCK LN, SALT LAKE CITY, UT 84117-4116
(706) 816-2827
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
92078202402
UT
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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