Individual
JESSICA LYNN GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
59 S 1100 E, SALT LAKE CITY, UT 84102-1508
(801) 754-6051
Mailing address
59 S 1100 E, SALT LAKE CITY, UT 84102-1508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9077851-1206
UT
363A00000X
Physician Assistant
9077851-8906
UT
Other
Enumeration date
07/16/2019
Last updated
03/08/2022
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