Individual
ABIGAIL BRIENN JACKETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
65 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84132-0005
(801) 581-2352
Mailing address
14181 S HOLLOW VISTA CV, HERRIMAN, UT 84096-3957
(801) 673-8383
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
187674
UT
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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