Individual
JEREMY CHRISTOPHER MCCORRISTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4782 S HOLLADAY BLVD, HOLLADAY, UT 84117-5444
(801) 277-7002
Mailing address
776 N CANTERBURY CT, SARATOGA SPRINGS, UT 84045-7003
(801) 400-9747
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7958137-2401
UT
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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