Organization
KG MEDICAL CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY Q. JACKSON (OWNER)
(801) 430-0282
Entity
Organization
Contact information
Practice address
231 E 200 N, AMERICAN FORK, UT 84003-1742
(801) 319-2772
Mailing address
2040 E MURRAY HOLLADAY RD STE 115, SLC, UT 84117-5139
(801) 430-0282
(801) 508-2273
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
7382930-0160
UT
Other
Enumeration date
07/11/2017
Last updated
06/16/2018
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