Individual
KERRY R TUTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT RL CLT LANA
Contact information
Practice address
1153 EAST 3900 SOUTH, SALT LAKE CITY, UT 84124
(801) 262-6331
(801) 262-3372
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171
(801) 942-3311
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
49759934201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D4699
—
UT
Enumeration date
09/02/2006
Last updated
07/08/2007
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