Individual
JEREMIAH J MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST
Contact information
Practice address
2513 W 2400 S, HEBER CITY, UT 84032-3624
(435) 671-0838
Mailing address
2513 W 2400 S, HEBER CITY, UT 84032-3624
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
246ZS0410X
Surgical Technologist
—
—
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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