Larson, Roger L.

Larson, Roger L. is an individual health care provider with primary practice located at 6040 Fashion Blvd Ste.# 200, Murray UT 84107-5417. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Larson, Roger L. can be contacted via phone (801) 266-7534.

Contact Information

Primary practice address
6040 Fashion Blvd Ste.# 200 Murray UT 84107-5417
Phone: (801) 266-7534
Fax: (801) 266-7547
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 105692-2401 Utah

Profile Details

NPI number 1699759357
LBN Legal business name Larson, Roger L.
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699759357 NPPES
Utah Other 64-05616 UNITED HEALTHCARE
Utah Other 107009228101 UNITED HEALTHCARE

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