# ROGER L LARSON RPT PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003060906
- **Authorized official:** ROGER L LARSON P.T. (PRESIDENT/OWNER)
- **Authorized official phone:** (801) 266-7534

## Contact information

- **Practice address:** 6040 FASHION BLVD, STE. \#200, MURRAY, UT 84107-5417
- **Practice address phone:** (801) 266-7534
- **Practice address fax:** (801) 266-7547
- **Mailing address:** 6040 FASHION BLVD, STE. \#200, MURRAY, UT 84107-5417
- **Mailing address phone:** (801) 266-7534
- **Mailing address fax:** (801) 266-7547

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 105692-2401 | UT | Yes |

## Other

- **Enumeration date:** 11/05/2008
- **Last updated:** 02/05/2009