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Individual

GAIL MARIETTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
5151 S 900 E, #100, SALT LAKE CITY, UT 84117-6601
(801) 261-3321
(801) 261-5942
Mailing address
5151 S 900 E, #100, SALT LAKE CITY, UT 84117-6657
(801) 261-3321
(801) 261-5942

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
111716-240
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11171624001001
BLUE CROSS BLUE SHIELD
UT
01
5417
DMBA
UT
01
6400386
UNITED HEALTHCARE
UT
01
68948
PEHP
UT
01
870388269BR1
EDUCATORS MUTUAL
UT
01
9951986
CIGNA
UT
01
CJ9402
RAILROAD MEDICARE
UT
01
QM0000060955
ALTIUS
UT
Enumeration date
08/03/2005
Last updated
05/02/2008
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