Individual
JORDAN EATOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-3367
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
12/11/2025
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