Individual
STEPHEN LAMARR SCOVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
5788 S WATERBURY WAY, UNIT B, SALT LAKE CITY, UT 84121-1141
(801) 662-9098
Mailing address
1115 S 900 E, SALT LAKE CITY, UT 84105-1323
(801) 662-9098
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7427208-4405
UT
Other
Enumeration date
09/30/2013
Last updated
04/07/2020
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