Individual
DR. JODY QUICK WIXOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1055 N 300 W STE 410, PROVO, UT 84604-3354
(801) 357-8818
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-8818
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5187987-1205
UT
Other
Enumeration date
05/25/2009
Last updated
09/05/2013
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