Organization
BRUCE K JACOBSON PH D P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE K JACOBSON PH D P C (PRESIDENT AND PSYCHOLOGIST)
(801) 272-0614
Entity
Organization
Contact information
Practice address
4190 HIGHLAND DR, SUITE 211, SALT LAKE CITY, UT 84124-2600
(801) 272-0614
(801) 272-0678
Mailing address
4190 HIGHLAND DR, SUITE 211, SALT LAKE CITY, UT 84124-2600
(801) 272-0614
(801) 272-0678
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1162592501
UT
Other
Enumeration date
04/26/2006
Last updated
03/16/2018
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