Individual
JILL WENNESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
1201 E 4500 S, HOLLADAY, UT 84117-4124
(801) 261-3664
Mailing address
1201 E 4500 S, HOLLADAY, UT 84117-4124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4803045-2401
UT
Other
Enumeration date
08/05/2012
Last updated
05/08/2013
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