Individual
JENNIFER B LITTLEDIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
210 MILLPOND, STANSBURY PARK, UT 84074-8187
(435) 843-3647
Mailing address
210 MILLPOND, STANSBURY PARK, UT 84074-8187
(435) 843-3647
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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