Individual
JAY P ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1300 N 500 E, LOGAN, UT 84341-2408
(435) 716-2880
Mailing address
PO BOX 25537, SALT LAKE CITY, UT 84125-0537
(435) 716-2880
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
53405374201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107030670103
IHC SELECT HEALTH
UT
05
—
D5302
—
UT
Enumeration date
07/31/2006
Last updated
04/03/2026
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