| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JOHN STAVAST | 1982050894 | 2024-08-11 |
John Stavast is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1982050894. Registration indicates John Stavast is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapist (Physical Therapist: Orthopedic, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapist Orthopedic, Respiratory, Developmental, Rehabilitative and Restorative Service Providers) (Physical Therapist, )
| Entity Type | Individual |
| Provider Name | John Stavast DPT |
| Practice Office Address | 526 W CENTER ST STE 105 PLEASANT GROVE, UT US |
| Practice Office Telephone | 8018993814 |
| Mailing Address | 526 W CENTER ST STE 105 PLEASANT GROVE, UT 840623359 US |
| Business Telephone | 8018993814 |
| Code | Practice | License No State |
|---|---|---|
| 2251X0800X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist Physical Therapist: Orthopedic Speech/Occupational/Physical Therapy/Chiropractor Physical Therapist Orthopedic Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | 12427493-2401
UT |