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1023848082
MICHAEL JACKSON
SALT LAKE CITY, UT
NPI
1023848082
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-08-05
Last Update Date
2024-08-05
Business Address
MICHAEL JACKSON
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 801-273-6335
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Mailing Address
MICHAEL JACKSON
3725 W 4100 S STE 201
WEST VALLEY CITY, UT 84120-5427
Phone number:
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