Individual
DR. TRAVIS C JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
617 E RIVERSIDE DR STE 104, ST GEORGE, UT 84790-8720
(435) 656-2059
(435) 656-3059
Mailing address
1508 BOYS POND CIR, SANTA CLARA, UT 84765-5736
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4911172-1701
UT
Other
Enumeration date
03/12/2012
Last updated
12/17/2020
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