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1386119238
TRAVIS CODY LARSEN
OREM, UT
NPI
1386119238
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 7420337-3501)
Enumeration Date
2018-10-08
Last Update Date
2018-10-08
Business Address
TRAVIS CODY LARSEN
360 S STATE ST STE 103
OREM, UT 84058-5745
Phone number: 801-377-1117
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Mailing Address
TRAVIS CODY LARSEN
729 W 1450 S
SPRINGVILLE, UT 84663-4710
Phone number: 435-590-5644
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