Individual
SCOTT MICHAEL JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
44 N MEDICAL DR, SALT LAKE CITY, UT 84113-1105
(801) 883-4646
Mailing address
1077 CLIFF SIDE CT, SANDY, UT 84094-0798
(801) 563-0708
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
283650-2401
UT
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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