Individual
PEGUY JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2008 E CHARIOT LN, SPANISH FORK, UT 84660-6284
(801) 623-3346
Mailing address
2008 E CHARIOT LN, SPANISH FORK, UT 84660-6284
(801) 623-3346
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9571169-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
9571169-4405
UT
Other
Enumeration date
10/06/2017
Last updated
07/14/2023
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