Individual
DR. LARRY BRAD PECK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
44 N MEDICAL DR, SLC, UT 84113-1105
(801) 584-8533
Mailing address
3908 S 2175 E, SLC, UT 84124-1718
(801) 647-8010
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
98-351353-2501
UT
Other
Enumeration date
05/08/2006
Last updated
07/08/2007
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