Individual
MR. JONATHAN DANIEL RICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
905 N 1000 W, TREMONTON, UT 84337-9356
(435) 207-4500
Mailing address
905 N 1000 W, TREMONTON, UT 84337-9356
(435) 207-4500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10297498-4405
UT
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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