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1134751902
JACIE ANNA MUNDAHL
SALT LAKE CITY, UT
NPI
1134751902
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 11609094-1206)
Enumeration Date
2020-02-10
Last Update Date
2020-02-10
Business Address
JACIE ANNA MUNDAHL PA-C
8TH AVE C ST E 80
SALT LAKE CITY, UT 84143-0001
Phone number: 801-408-1100
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Mailing Address
JACIE ANNA MUNDAHL PA-C
6008 37TH AVE NE
RUGBY, ND 58368-8760
Phone number: 701-771-0134
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