Individual
JADE IVETT MARROQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 907-4750
Mailing address
PO BOX 651, MAGNA, UT 84044-0651
(801) 403-9726
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
12054790
UT
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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