Individual
JECEL KEVIN MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
JECEL
Contact information
Practice address
1109 W 1390 S, OREM, UT 84058
(801) 376-9929
Mailing address
750 NORTH FREEDOM BLVD, PROVO, UT 84601
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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