Individual
GILLIAN BERAN-MARYOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
165 S 1000 E, SALT LAKE CITY, UT 84102-1402
(801) 322-5521
Mailing address
2550 S MAIN ST APT 4309, SOUTH SALT LAKE, UT 84115-3078
(503) 896-6080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11819269-2401
UT
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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