Individual
JACOB PROFFIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Contact information
Practice address
209 W 300 N, LOGAN, UT 84321-3809
(435) 716-8535
Mailing address
9195 N 6400 W, TREMONTON, UT 84337-8603
(425) 512-2951
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11965771-2401
UT
2255A2300X
Athletic Trainer
11965771-4810
UT
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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