Individual
STACY M. ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
250 E 200 S RM 1202, SALT LAKE CITY, UT 84111-2472
(801) 581-4800
Mailing address
250 E 200 S RM 1202, SALT LAKE CITY, UT 84111-2472
(801) 581-4800
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
02004744A
IN
2083X0100X
Occupational Medicine Physician
Primary
11899067-1204
UT
Other
Enumeration date
04/15/2014
Last updated
09/23/2021
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