Individual
JAN M CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5495 S 500 E, STE 120, OGDEN, UT 84405-6923
(801) 479-0174
(801) 479-8888
Mailing address
5495 S 500 E, STE 120, OGDEN, UT 84405-6923
(801) 479-0174
(801) 479-8888
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
198466-1206
UT
Other
Enumeration date
06/21/2007
Last updated
06/27/2008
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