Individual
ZACKERY ROSS WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
5169 S COTTONWOOD ST # 510, MURRAY, UT 84107-6767
(801) 507-3513
(801) 507-3584
Mailing address
2800 W 7460 S, WEST JORDAN, UT 84084-3731
(801) 903-3859
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6860371-4405
UT
Other
Enumeration date
04/03/2018
Last updated
04/03/2018
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