Individual
ZACKERY CHAD LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSS
Contact information
Practice address
1336 S 1100 E, SALT LAKE CITY, UT 84105-2421
(385) 246-2522
(801) 810-1343
Mailing address
1336 S 1100 E, SALT LAKE CITY, UT 84105-2421
(385) 246-2522
(801) 810-1343
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
UT
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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