Individual
JACOB EUGENE OSTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4077 S GARY RD, SALT LAKE CITY, UT 84124-2311
(801) 554-2336
Mailing address
4077 S GARY RD, SALT LAKE CITY, UT 84124-2311
(801) 554-2336
(801) 554-2336
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12309986-3501
UT
171M00000X
Case Manager/Care Coordinator
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Other
Enumeration date
11/10/2019
Last updated
03/06/2024
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