Individual
JACOB KORISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
9450 S 1300 E, SANDY, UT 84094-5555
(801) 501-2133
Mailing address
860 E 300 S APT 33, SALT LAKE CITY, UT 84102-2331
(563) 258-1505
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11169484-2401
UT
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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