Individual
JEREMIAH M EVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
373 E 700 S, SALT LAKE CITY, UT 84111-4046
(541) 908-6335
Mailing address
373 E 700 S, SALT LAKE CITY, UT 84111-4046
(541) 908-6335
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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