Pucillo, Evan Michael

Pucillo, Evan Michael is an sole proprietor health care provider with primary practice located at 50 N Medical Dr 1R 5 Som, Salt Lake City UT 84132-0001. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurology, which is considered as his primary health care specialty. Pucillo, Evan Michael can be contacted via phone (801) 585-5323.

Contact Information

Primary practice address
50 N Medical Dr 1R 5 Som Salt Lake City UT 84132-0001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurology 2251N0400X 9083705-2401 Utah

Profile Details

NPI number 1578961041
LBN Legal business name Pucillo, Evan Michael
Credentials PT, DPT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2014
Last updated Sep 22nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers