Individual
NICOLE MARIE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5974 FASHION POINT DR, #100, OGDEN, UT 84403-4699
(801) 479-9644
Mailing address
5522 S 1025 E, OGDEN, UT 84405-7074
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8167861-2402
UT
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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