Individual
JESSE JESSUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-4980
Mailing address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7784769-2401
UT
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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