Individual
JEFFERY KINGSOLVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1067 N 500 W, PROVO, UT 84604-3305
(801) 226-0599
(801) 226-3145
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(801) 294-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3379892401
UT
Other
Enumeration date
10/25/2006
Last updated
07/26/2010
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