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Individual

SHANNON SMALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
114 E 800 N, SPANISH FORK, UT 84660-1209
(801) 794-1490
Mailing address
114 E 800 N, SPANISH FORK, UT 84660-1209
(801) 794-1490

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
204009858
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063481646
NPI
UT
01
1194744615
NPI
UT
01
1821299751
NPI
UT
Enumeration date
04/19/2017
Last updated
04/19/2017
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