JACOB PENROSE

LOGAN, UT
NPI1811445216
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: UT  8076772-2401)
Enumeration Date2016-09-14
Last Update Date2016-09-14
Business Address
JACOB PENROSE DPT, CWS
209 W 300 N
LOGAN, UT 84321-3809
Phone number: 435-716-8535
Mailing Address
JACOB PENROSE DPT, CWS
577 E 620 N
SMITHFIELD, UT 84335-6734
Phone number: 435-938-8504
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