Individual
JORDAN EDWIN TAZOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7005
Mailing address
1869 S 500 E APT B, SLC, UT 84105-2931
(801) 694-5835
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10387416-2401
UT
Other
Enumeration date
05/31/2017
Last updated
11/23/2021
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