Provider Demographics
NPI:1821274523
Name:WEBB, PAUL EUGENE (MS, ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EUGENE
Last Name:WEBB
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 W 410 N
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4663
Mailing Address - Country:US
Mailing Address - Phone:435-669-2656
Mailing Address - Fax:
Practice Address - Street 1:1438 W 410 N
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4663
Practice Address - Country:US
Practice Address - Phone:435-669-2656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0506133171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor