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Individual

NATHAN A STOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7655 S 2700 W, APT. B, WEST JORDAN, UT 84084-3803
(801) 540-0688
Mailing address
7655 S 2700 W, APT. B, WEST JORDAN, UT 84084-3803

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
69840251702
UT

Other

Enumeration date
08/31/2010
Last updated
08/31/2010
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