Individual
TAVIN DERU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
775 N 200 E, BRIGHAM CITY, UT 84302-1303
(435) 723-7777
Mailing address
206 N 2100 W, SALT LAKE CITY, UT 84116-4740
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10429475-4201
UT
Other
Enumeration date
04/02/2018
Last updated
10/24/2021
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