Individual
DR. JEFFERY BLYTHE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., CCC-A
Contact information
Practice address
1000 OLD MAIN HL, COMD DEPARTMENT, UMC 1000, LOGAN, UT 84322-1000
(435) 797-1390
Mailing address
6410 OLD MAIN HL, LOGAN, UT 84322-6410
(435) 797-1373
(844) 308-5865
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
6207896-4101
UT
Other
Enumeration date
02/11/2010
Last updated
11/13/2018
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