Individual
PATRICK R JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
548 N 1100 E, WASHINGTON, UT 84780-2980
(435) 275-4458
(435) 275-4407
Mailing address
PO BOX 911415, ST GEORGE, UT 84791-1415
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/22/2017
Last updated
09/22/2017
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