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:
Health care specialties
| Specialty | Code | License # | 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 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699759357 | NPPES |
| Utah | Other | 64-05616 | UNITED HEALTHCARE |
| Utah | Other | 107009228101 | UNITED HEALTHCARE |
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