Individual
MICHAEL PHILLIP GERSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1205 N FAIRFIELD RD, LAYTON, UT 84041-8300
(801) 876-5980
Mailing address
251 PARK BLVD APT 211, OGDEN, UT 84401-0553
(248) 875-5036
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12104034-2402
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12104034-2402
PTA LICENSE NUMBER
UT
Enumeration date
05/13/2021
Last updated
05/13/2021
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