Individual
JORDAN BLAZOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1155 E 2100 S APT 726, SALT LAKE CITY, UT 84106-6805
(307) 371-2628
Mailing address
1155 E 2100 S APT 726, SALT LAKE CITY, UT 84106-6805
(307) 371-2628
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14412220
—
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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