Individual
JEREMY KEVIN ENSIGN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1628 W 11010 S STE 101, SOUTH JORDAN, UT 84095-1278
(801) 613-1890
(801) 613-2909
Mailing address
1628 W 11010 S STE 101, SOUTH JORDAN, UT 84095-1278
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13960851-2401
UT
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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