Individual
JERIN H LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1013 W 2700 S, SYRACUSE, UT 84075-8973
(801) 774-7540
Mailing address
1013 W 2700 S, SYRACUSE, UT 84075-8973
(801) 774-7540
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
14252296-1202
UT
Other
Enumeration date
10/16/2025
Last updated
10/16/2025
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