Individual
DEREK LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
76 S 500 E, SALT LAKE CITY, UT 84102-1044
(801) 359-0050
Mailing address
3423 S 100 W, BOUNTIFUL, UT 84010-6639
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9066136-4201
UT
Other
Enumeration date
10/21/2019
Last updated
12/15/2021
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