Individual
JADE JAQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5323 S WOODROW ST STE 101, MURRAY, UT 84107-5843
(801) 313-7500
Mailing address
5323 S WOODROW ST STE 102, MURRAY, UT 84107-5853
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13030936-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2022
Last updated
12/21/2023
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