Individual
JUSTIN ROBERT HASLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
5740 CRESTWOOD DR, OGDEN, UT 84405-4869
(801) 479-7771
(801) 479-7795
Mailing address
5740 CRESTWOOD DR, OGDEN, UT 84405-4869
(801) 479-7771
(801) 479-7795
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9137974-4405
UT
Other
Enumeration date
08/09/2020
Last updated
09/01/2020
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