Individual
SPENCER T. LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 E 200 S, SALT LAKE CITY, UT 84102-2110
(801) 428-3436
Mailing address
607 E 200 S, SALT LAKE CITY, UT 84102-2110
(801) 428-3436
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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