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Individual

JACOB CORRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1303 N MAIN ST, STE 3C, CEDAR CITY, UT 84721-9746
(435) 868-5500
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 868-5500

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11014585
IN
207Q00000X
Family Medicine Physician
Primary
7850776-1204
UT

Other

Enumeration date
07/08/2008
Last updated
10/05/2011
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