Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 6601669-4201 | UT |
NPI | 1033757257 |
---|---|
Provider Name | Joshua David Parry |
First Address | West Jordan, UT 84081-4101 |
Second Address | Murray, UT 84107-6165 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |