Individual
SPENCER G MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
800 W UNIVERSITY PKWY, OREM, UT 84058-6703
(801) 863-6784
Mailing address
935 E 80 S, OREM, UT 84097-5774
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
475641-4810
UT
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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