Stacy Probasco

NPI #1730639543 in Layton, Utah

Provider Information

NPI Number: 1730639543
Entity Type: Individual
Name: Stacy Probasco
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Oct 5, 2016
Last Updated: Oct 5, 2016

Practice Location

Address: 2121 N 1700 W
City: Layton
State: Utah
ZIP Code: 84041-8803
Phone: (801) 773-4840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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