Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 225X00000X | UT |
N | 225XH1200X | Occupational Therapist - Hand | 225XH1200X | UT |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 225XP0019X | UT |
NPI | 1235539057 |
---|---|
Provider Name | Mr. James Bowie Jeffs |
First Address | St George, UT 84790-6124 |
Second Address | St George, UT 84790-6124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2014 |
Last Update Date | 28/08/2014 |