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Individual

JAMIE KINGDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
652 EAGLEPOINTE DR, NORTH SALT LAKE, UT 84054-2643
(801) 638-7785
Mailing address
652 EAGLEPOINTE DR, NORTH SALT LAKE, UT 84054-2643
(801) 638-7785

Taxonomy

Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
119740-2401
UT

Other

Enumeration date
03/21/2017
Last updated
03/21/2017
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