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Individual

ROGER E PACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
412 W. 800 N., OREM, UT 84057
(801) 701-6515
Mailing address
PO BOX 657, OREM, UT 84059-0657
(801) 225-6246
(801) 225-1525

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1193062401
UT

Other

Enumeration date
08/21/2006
Last updated
11/20/2007
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