Provider Demographics
NPI:1659496123
Name:STOKES, CORWIN WESLEY (MSPT)
Entity Type:Individual
Prefix:MR
First Name:CORWIN
Middle Name:WESLEY
Last Name:STOKES
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1692 W 1000 S
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4821
Mailing Address - Country:US
Mailing Address - Phone:801-766-6741
Mailing Address - Fax:
Practice Address - Street 1:76 S 500 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1044
Practice Address - Country:US
Practice Address - Phone:801-359-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4940871-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist