Individual
DIANE VERA PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1952 E 7000 S, SALT LAKE CITY, UT 84121-6877
(801) 942-3311
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171-1185
(801) 942-3311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11403547-2401
UTAH DOPL
UT
Enumeration date
02/24/2020
Last updated
02/24/2020
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