Individual
STEPHEN M SHUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., P.T., O.C.S.
Contact information
Practice address
2295 FOOTHILL DR, SALT LAKE CITY, UT 84109-4000
(801) 486-7542
Mailing address
2295 FOOTHILL DR, SALT LAKE CITY, UT 84109-4000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
110838-2401
UT
Other
Enumeration date
08/21/2006
Last updated
07/06/2010
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