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Individual

STEPHANIE LYNN FAGIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

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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