Individual
JORDAN CLARK ESTEBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 S 500 E, SALT LAKE CITY, UT 84102-2705
(801) 359-8862
Mailing address
704 E OSBORNE ESTATE CIR, DRAPER, UT 84020-8259
(801) 669-7908
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11788173-3506
UT
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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