Individual
JESSIE BALICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
523 N MAIN ST, BOUNTIFUL, UT 84010-6036
(801) 951-2273
Mailing address
206 N 2100 W, SALT LAKE CITY, UT 84116-4740
(801) 456-8409
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9251212-2401
UT
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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