Individual
LARRY DAVID CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUDC
Contact information
Practice address
996 W 800 S, PAYSON, UT 84651-2766
(801) 465-5111
Mailing address
996 W 800 S, PAYSON, UT 84651-2766
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
110097539-6018
UT
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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