Individual
JACOB LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD
Contact information
Practice address
1992 W ANTELOPE DR, SUITE 1-D, LAYTON, UT 84041-4953
(801) 773-2633
(801) 773-1553
Mailing address
1992 W ANTELOPE DR, SUITE 1-D, LAYTON, UT 84041-4953
(801) 773-2633
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
9829767-4201
UT
Other
Enumeration date
08/27/2016
Last updated
08/27/2016
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