Individual
J ADELLE TWIBEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3875 S 4950 W, WEST HAVEN, UT 84401-6829
(801) 821-7569
Mailing address
3875 S 4950 W, WEST HAVEN, UT 84401-6829
(801) 821-7569
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
116591-2401
UT
225100000X
Physical Therapist
PT-559
ID
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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