Provider Demographics
NPI:1578744835
Name:JARVIS, FRANK CHARLES (MS, CCC-A)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:CHARLES
Last Name:JARVIS
Suffix:
Gender:M
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S FAIRFIELD RD
Mailing Address - Street 2:SUITE #10
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5111
Mailing Address - Country:US
Mailing Address - Phone:801-546-7487
Mailing Address - Fax:801-497-9301
Practice Address - Street 1:5642 S 900 E
Practice Address - Street 2:SUITE 1
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-1060
Practice Address - Country:US
Practice Address - Phone:801-713-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6777345-4101237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1578744835Medicaid
UT334631OtherALTIUS
UT334631OtherALTIUS