Individual
TODD POULSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Contact information
Practice address
3430 HARRISON BLVD, OGDEN, UT 84403-1231
(801) 399-5609
Mailing address
1071 W 275 S, LAYTON, UT 84041-5247
(801) 593-8136
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
336746-4201
UT
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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