Provider Demographics
NPI:1356414718
Name:SATTESON, JACK F (OTR/L)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:F
Last Name:SATTESON
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:884 RATTLER RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045
Mailing Address - Country:US
Mailing Address - Phone:801-768-1777
Mailing Address - Fax:
Practice Address - Street 1:797 E 640 N
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-1647
Practice Address - Country:US
Practice Address - Phone:801-426-4905
Practice Address - Fax:801-281-9243
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3397774201224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant