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Individual

JASON WOODBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
575 E 1400 S, OREM, UT 84097-7707
(801) 225-4741
Mailing address
1551 S 125 E, OREM, UT 84058-7677
(801) 765-7585

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
7021811-4201
ID
225X00000X
Occupational Therapist
Primary
OT-993
ID

Other

Enumeration date
07/27/2011
Last updated
07/27/2011
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