JEREMY LARSEN

PROVO, UT
NPI1598127169
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101Y00000X Counselor
Enumeration Date2016-03-23
Last Update Date2021-10-11
Business Address
JEREMY LARSEN
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
Mailing Address
JEREMY LARSEN
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760