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Individual

MR. JOSHUA BRYAN UTAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO, LPO

Contact information

Practice address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
Mailing address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
1064
TX
224P00000X
Prosthetist
Primary
1064
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1064
TEXAS DEPT. OF LICENSING AND REGULATION
TX
Enumeration date
07/26/2018
Last updated
02/24/2022
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