Individual
JOSHUA JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN ABO, NCLE
Contact information
Practice address
2754 W 3500 N, FARR WEST, UT 84404-8612
(801) 558-6357
Mailing address
2754 W 3500 N, FARR WEST, UT 84404-8612
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
178584
UT
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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