Individual
MR. ROGER L. LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
105692-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107009228101
INTERMOUNTAIN HEALTHCARE
UT
01
—
64-05616
UNITED HEALTHCARE
UT
Enumeration date
12/05/2005
Last updated
07/13/2026
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