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Individual

BRET IRA JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1647 S 1280 W, LOGAN, UT 84321-6867
(435) 512-6377
Mailing address
1647 S 1280 W, LOGAN, UT 84321-6867
(435) 512-6377

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
UT

Other

Enumeration date
12/09/2008
Last updated
12/09/2008
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