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Individual

JOEL MARK MANWILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
3327 N 1050 E, LAYTON, UT 84040-6524
(801) 771-2073
Mailing address
127 S. 500 E., SUITE 600, SALT LAKE CITY, UT 84102-1971
(801) 587-6336
(801) 715-8228

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
225XP0200X
Pediatric Occupational Therapist
314601-4201
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
999000021033
UT
Enumeration date
03/08/2007
Last updated
02/15/2019
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