Most Relevant Information
Provider Data
| NPI Number: | 1003455189 |
| Provider Name: | SPENCER CLYDE STEVENS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/06/2020 |
| Last Updated: | 01/06/2020 |
Provider Practice Location
344 E 100 S
SALT LAKE CITY
UT
841111700
Practice Location Phone/Fax
| Phone: | 8013223222 |
| Fax: |
Provider Mailing Location
344 E 100 S
SALT LAKE CITY
UT
841111700
Provider Mailing Phone/Fax
| Phone: | 8013223222 |
| Fax: |