Individual
JACK CASTELLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4162 S DAVENCREST LN, TAYLORSVILLE, UT 84129-5368
(801) 859-5950
Mailing address
4162 S DAVENCREST LN, TAYLORSVILLE, UT 84129-5368
(801) 859-5950
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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