Individual
KEOLA THANE STONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
5600 S 2700 W, ROY, UT 84067-1336
(208) 869-0988
Mailing address
532 W 5350 S, RIVERDALE, UT 84405-6743
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8207091-4204
UT
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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