Individual
MR. JONATHAN DEAN FLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
980 W 1275 S, SPRINGVILLE, UT 84663-5058
(801) 380-2538
Mailing address
980 W 1275 S, SPRINGVILLE, UT 84663-5058
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11269438-4405
UT
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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