Individual
JORDON LEBARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1188 RAYMOND RD, FRUIT HEIGHTS, UT 84037-2252
(801) 698-6250
Mailing address
1188 E RAYMOND RD, FRUIT HEIGHTS, UT 84037
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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