Individual
LARA CAMERON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4617 S PIONEER RD STE 103, ST GEORGE, UT 84790-5156
(435) 767-9094
Mailing address
2421 E 390 N, SAINT GEORGE, UT 84790-1117
(209) 324-8727
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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