Individual
MR. JEDEDIAH S BRISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1060 E 100 S, SALT LAKE CITY, UT 84102-1501
(801) 350-4110
Mailing address
1060 E 100 S, SALT LAKE CITY, UT 84102-1501
(801) 350-4110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
334170-4408
UT
Other
Enumeration date
08/29/2008
Last updated
10/13/2008
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