Individual
JEFFREY JAY MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1370 S WEST TEMPLE, SOUTH SALT LAKE, UT 84115-5218
(801) 893-8417
Mailing address
1370 S WEST TEMPLE, SOUTH SALT LAKE, UT 84115-5218
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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