Individual
STEPHANIE LYNN FAGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1112 BURNT FORK RD, SALT LAKE CITY, UT 84108-1756
(801) 598-8777
Mailing address
1112 BURNT FORK RD, SALT LAKE CITY, UT 84108-1756
(801) 598-8777
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
329509-2401
UT
225100000X
Physical Therapist
Primary
329509
UT
Other
Enumeration date
12/16/2010
Last updated
10/25/2021
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