NPI 1558177949

Jeffery Rolla Landis

Practitioner Peer Specialist Slc, UT

Practice location

Address: 1875 S Redwood Rd, Slc, UT 84104-5112
Phone: (801) 355-2846

Registered specialties (2)

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Registry record

NPI: 1558177949
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Dec 2024
Record last updated: 10 Dec 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.