Individual
JEREMY RUSSEL HARMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
324 E 10TH AVE, SUITE 100, SALT LAKE CITY, UT 84103-2853
(801) 408-7660
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-7660
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7095823-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830712
—
AZ
Enumeration date
10/25/2005
Last updated
01/28/2016
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