Jacob Penrose, DPT, CWS

NPI #1811445216 in Logan, Utah

Provider Information

NPI Number: 1811445216
Entity Type: Individual
Name: Jacob Penrose, DPT, CWS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: DPT, CWS
Enumeration Date: Sep 14, 2016
Last Updated: Sep 14, 2016

Practice Location

Address: 209 W 300 N
City: Logan
State: Utah
ZIP Code: 84321-3809
Phone: (435) 716-8535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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