Individual
MATTHEW ADRIAN JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
447 BEARCAT DR, SALT LAKE CITY, UT 84115-2519
(801) 355-2846
(801) 359-3244
Mailing address
447 BEARCAT DR, SALT LAKE CITY, UT 84115-2519
(801) 355-2846
(801) 359-3244
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
UT
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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