Individual
MS. JODY R JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MTRS MED
Contact information
Practice address
50 NORTH MEDICAL DR, SALT LAKE, UT 84132
(801) 339-9489
Mailing address
2820 OQUIRRH DR, SALT LAKE CITY, UT 84108-2036
(801) 466-4141
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
1026934001
UT
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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