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1114506714
JORDAN D. DESAUTELS
SALT LAKE CITY, UT
NPI
1114506714
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207W00000X Ophthalmology
(Licence: UT 12974670-1205)
Enumeration Date
2021-04-02
Last Update Date
2022-08-15
Business Address
JORDAN D. DESAUTELS MD
65 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84132-0002
Phone number: 801-585-6701
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Mailing Address
JORDAN D. DESAUTELS MD
65 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84132-0002
Phone number: 801-585-6701
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