Individual
JACOB HOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L WCC
Contact information
Practice address
4753 N PEARLY LN, ENOCH, UT 84721-7489
(435) 590-2478
Mailing address
4753 N PEARLY LN, ENOCH, UT 84721-7489
(435) 590-2478
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7257853-4201
UT
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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