Individual
NICOLETTE JANE REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7601 S REDWOOD RD, E, WEST JORDAN, UT 84084-4007
(801) 233-8670
(801) 233-8682
Mailing address
58 E MUTTON HOLLOW RD, KAYSVILLE, UT 84037-1257
(385) 240-7700
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/21/2016
Last updated
01/11/2017
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