Individual
JEFFERY JON HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
184 NORTH 200 WEST, KOOSHAREM, UT 84744
(435) 231-1244
Mailing address
184 NORTH 200 WEST, KOOSHAREM, UT 84744
(435) 231-1244
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
267947-3101
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267947-3101
—
UT
Enumeration date
06/18/2010
Last updated
06/18/2010
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