Individual
GLEN I JUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
323 W HALEYS LOOKOUT, ELK RIDGE, UT 84651-4564
(801) 472-2452
Mailing address
323 W HALEYS LOOKOUT, ELK RIDGE, UT 84651-4564
(801) 472-2452
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
360342-3102
UT
163W00000X
Registered Nurse
663310
CA
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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