Individual
JARED LANDVATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPCI
Contact information
Practice address
475 W 50 N, ALPINE CENTER FOR BEHAVIORAL HEALTH, AMERICAN FORK, UT 84003
(801) 756-3664
Mailing address
475 W 50 N, AMERICAN FORK, UT 84003
(801) 756-3664
(701) 756-3698
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2702096009
UT
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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