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Matthew Jackman
NPI 1891071973 · on the registry since 2011 · sole proprietor
Practice
- Address
- 447 Bearcat Dr
Salt Lake City, UT 84115 - Phone
- (801) 355-2846
- Fax
- (801) 359-3244
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-11-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah