Individual
JACOB DANIEL CHRISTIANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5171 S COTTONWOOD ST STE 810, SALT LAKE CITY, UT 84107-5705
(801) 507-9800
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-9800
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
10483143-1204
UT
Other
Enumeration date
04/12/2016
Last updated
07/13/2023
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