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1609105113
JEREMY LEE COULSON
PROVO, UT
NPI
1609105113
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: UT 7304827-2401)
Enumeration Date
2009-12-11
Last Update Date
2009-12-11
Business Address
-- JEREMY LEE COULSON PT
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-7475
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Mailing Address
-- JEREMY LEE COULSON PT
PO BOX 30180
SALT LAKE CITY, UT 84130-0180
Phone number:
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