Individual
JACOB PETERSON POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
475 HOSPITAL DR, OREM, UT 84057
(801) 221-9930
Mailing address
674 W 640 N, OREM, UT 84057-3665
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12699294-2401
UT
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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