JACOB IVAN

LAYTON, UT
NPI1134979347
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: UT  14234161-1205)
Enumeration Date2024-03-22
Last Update Date2025-11-18
Business Address
JACOB IVAN
201 W LAYTON PKWY STE 1A
LAYTON, UT 84041-3692
Phone number: 801-543-6875
Mailing Address
JACOB IVAN
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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