Provider Demographics
NPI:1710073523
Name:JARMAN, KAM E (MPT)
Entity Type:Individual
Prefix:
First Name:KAM
Middle Name:E
Last Name:JARMAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WEST 50 SOUTH
Mailing Address - Street 2:PO BOX 276
Mailing Address - City:GARDEN CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84028
Mailing Address - Country:US
Mailing Address - Phone:435-946-2777
Mailing Address - Fax:435-946-9777
Practice Address - Street 1:95 WEST 50 SOUTH
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:UT
Practice Address - Zip Code:84028
Practice Address - Country:US
Practice Address - Phone:435-946-2777
Practice Address - Fax:435-946-9777
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3519742401225100000X
IDPT1256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT$$$$$$$$$001Medicaid
UTS61283Medicare UPIN
ID1651375Medicare PIN