NPI 1467513713

Debra Willardson, ATC

Practitioner Other Specialist/Technologist Salt Lake City, UT

Practice location

Address: 1825 E South Campus Dr Athletics Dept., Salt Lake City, UT 84112-0900
Phone: (801) 581-4836
Fax: (801) 585-5005
Mailing address: 1825 E South Campus Dr Atheltics Dept., Slc, UT 84112-0900

Registered specialties

Other Specialist/Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246Z00000X Licence 1216584810 (UT)

Other Specialist/Technologist, Other providers in Utah →

Registry record

NPI: 1467513713
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Dec 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.