Provider Demographics
NPI:1508059643
Name:LAJOM, JEANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:
Last Name:LAJOM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7756 ASH BRIAR LN
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-2835
Mailing Address - Country:US
Mailing Address - Phone:801-446-0990
Mailing Address - Fax:801-446-0909
Practice Address - Street 1:1738 W 12600 S
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7025
Practice Address - Country:US
Practice Address - Phone:801-446-0990
Practice Address - Fax:801-446-0909
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5283166-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist