| Bonnie Larsen, | |
|
100 Mario Capecchi Dr, Slc, UT 84113-1103 | |
| (801) 755-3792 | |
| Not Available |
| Full Name | Bonnie Larsen |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Neurorehabilitation |
| Location | 100 Mario Capecchi Dr, Slc, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578962007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XN1300X | Occupational Therapist - Neurorehabilitation | 6609718-4201 (Utah) | Primary |
| 225XP0200X | Occupational Therapist - Pediatrics | 6609718-4201 (Utah) | Secondary |
| Provider Name | Ihc Health Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1033822085 PECOS PAC ID: 1850209420 Enrollment ID: O20230627000064 |
| Mailing Address | Practice Location Address |
|---|---|
| Bonnie Larsen, 1183 University Vlg, Slc, UT 84108-3505 Ph: () - | Bonnie Larsen, 100 Mario Capecchi Dr, Slc, UT 84113-1103 Ph: (801) 755-3792 |
Katherine A Hughes, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Slc, UT 84113 Phone: 801-588-2000 | |
Paul Alan Arnold, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 50 N Medical Dr, Slc, UT 84132 Phone: 435-630-0934 | |
Jessica Elizabeth Smith, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 50 N Medical Dr, Slc, UT 84132 Phone: 801-587-3422 | |
Eric Mathew Nielson, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6246 So Redwood Rd, Avalon Bennion Care Center, Slc, UT 84123 Phone: 801-955-0690 Fax: 801-955-2540 | |
Miss Lindey Dawn Workman, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 50 N Medical Dr, Slc, UT 84132 Phone: 801-581-2733 | |
Samantha Corbridge, RBT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 50 N Medical Dr, Slc, UT 84132 Phone: 435-753-6606 | |
Kathrine M Detemple, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 590 Wakara Way, Slc, UT 84108 Phone: 801-587-7001 |