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Contact Information

ROBERT J LARSEN, MPT ATG
1551 S RENAISSANCE TWN DR
SUITE 420
BOUNTIFUL, UT84010
 Phone: 801-295-8999
 Fax: 801-292-4168
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ROBERT J LARSEN · (Male)

NPI # 1124111372
Status Active
Credentials MPT ATG
Entity Individual
Enumeration date 10/02/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 2780262401
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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