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1972908762
JACOB LARRY BUTLER
PROVO, UT
NPI
1972908762
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: UT 11351103-4201)
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2014-10-23
Last Update Date
2021-11-08
Business Address
JACOB LARRY BUTLER
1034 N 500 W
PROVO, UT 84604-3337
Phone number: 801-357-7850
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Mailing Address
JACOB LARRY BUTLER
3613 E GOLDEN EAGLE RD
EAGLE MOUNTAIN, UT 84005-3866
Phone number: 435-650-7021
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