NPI 1376619080 · live from the CMS NPI Registry
Jacob Raymond Bryan, MOTR L
Occupational Therapist in Brigham City, UT. National Provider Identifier 1376619080, active.
NPI record
| NPI | 1376619080 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Occupational Therapist 225X00000X |
| Practice location | 815 S 200 W, Brigham City, UT 84302 |
| Practice phone | 435-723-5289 |
| Mailing address | 828 E 350 S, Brigham City, UT 84302 |
| Enumerated | November 27, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapist primary | 225X00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.