Individual
JACOB COLBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1480 N 400 E, LOGAN, UT 84341-7525
(801) 808-4115
Mailing address
1480 N 400 E, LOGAN, UT 84341-7525
(801) 808-4115
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11055192-4201
UT
Other
Enumeration date
10/27/2019
Last updated
10/27/2019
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