Individual
DOMINIQUE STAY TECKLENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
435 S 660 W, OREM, UT 84058-6078
(801) 691-4980
Mailing address
435 S 660 W, OREM, UT 84058-6078
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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