Individual
JENNIFER JEAN BURGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4600 HIGHLAND DR, SALT LAKE CITY, UT 84117-5108
(801) 272-1892
Mailing address
6881 GRAND VALLEY PL, WEST JORDAN, UT 84084-8106
(801) 963-8379
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5345341-4202
UT
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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