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General NPI Number Information
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NPI Number | 1265251284
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Entity Type | Individual
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Provider Name | NATHAN STONE MS, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 241 N 300 W
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City | SALT LAKE CITY
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State | UT
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Zip | 84103-1100
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Country | US
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Telephone | 801-578-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 950 N CUTLER DR APT 828
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-5056
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Country | US
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Telephone | 801-520-3584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 9838361-4810
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License Number State | UT
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