Individual
JORDAN ROBERT MCQUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
24 S 1100 E, SUITE 101, SALT LAKE CITY, UT 84102-1500
(801) 355-6468
(801) 355-3450
Mailing address
24 S 1100 E, SUITE 101, SALT LAKE CITY, UT 84102-1500
(801) 355-6468
(801) 355-3450
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
8105342-1206
UT
Other
Enumeration date
09/30/2011
Last updated
11/20/2021
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