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1033143508
JACK D WAHLEN
OGDEN, UT
NPI
1033143508
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
(Licence: UT 791639051205)
Enumeration Date
2006-07-10
Last Update Date
2008-02-26
Business Address
Dr. JACK D WAHLEN M.D.
4403 HARRISON BLVD STE 3630
OGDEN, UT 84403-3271
Phone number: 801-387-7900
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Mailing Address
Dr. JACK D WAHLEN M.D.
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-387-7900
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