Individual
JESSE GRAYDON ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4747 N OREGON TRL, ENOCH, UT 84721-7443
(435) 586-2592
Mailing address
4747 N OREGON TRL, ENOCH, UT 84721-7443
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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