Individual
DR. JARED W HENRICKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MARIO CAPECCHI DR, SLC, UT 84113-1103
(801) 662-1000
Mailing address
295 CHIPETA WAY, PO BOX 581289, SLC, UT 84108-1287
(801) 587-7563
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
347933-1205
UT
Other
Enumeration date
07/16/2006
Last updated
04/25/2022
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