Individual
JIMMY S BOTTOMS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
523 N MAIN STREET, BOUTIFUL, UT 84010
(801) 951-1607
(801) 951-1700
Mailing address
1437 W 2150 SO, SYRACUSE, UT 84075
(801) 773-2987
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
59430442401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D6682
—
UT
Enumeration date
11/14/2006
Last updated
07/08/2007
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