Individual
TRACI ROBERTA MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E 5350 S, OGDEN, UT 84405-6931
(801) 479-9855
Mailing address
2240 N 225 E UNIT 53, NORTH OGDEN, UT 84414-2589
(406) 788-2032
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2357
MT
Other
Enumeration date
11/28/2012
Last updated
10/01/2014
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