Individual
JACQUELYN GRAVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2843
Mailing address
127 S. 500 E., SUITE 600, SALT LAKE CITY, UT 84102-1971
(801) 587-6336
(801) 715-8228
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9307924-8016
UT
Other
Enumeration date
06/11/2015
Last updated
12/10/2021
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