Stacey Bank

NPI 1790797959 - Family Medicine - 207Q00000X

NPI Details
NPI 1790797959
Gender Female
Enumeration Date 08/13/2006
Last Updated 07/10/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
4465 S 900 E
SUITE 200
SALT LAKE CITY UT, 84124-2456, US
Phone (801) 266-2777
Fax (801) 266-1377
Business Location
4465 S 900 E
SUITE 200
SALT LAKE CITY UT, 84124-2456, US
Phone (801) 266-2777
Fax (801) 266-1377
Toxanomy
Taxonomy Code 207Q00000X
License State Utah
License Number 5391997-1205
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According to our database, Stacey Bank NPI is 1790797959, taxonomy code is 207Q00000X and license number is 5391997-1205, license state is located at Utah. Stacey Bank physically located at 4465 S 900 E, Salt Lake City UT, 84124-2456. NPI Number Stacey Bank has the Individual type.

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1790797959 NPI number is provided on an as is basis without warranty of any kind. 1790797959 is maintained by the National Plan & Provider Enumeration System. The contents of Stacey Bank are for informational purposes only.