Individual
JASON W JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
525 N MAIN ST, EPHRAIM, UT 84627-1155
(435) 283-4076
Mailing address
561 N 2400 W, PROVO, UT 84601-7268
(435) 469-1364
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10528188-1206
UT
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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