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1194505248
BREANNA S JACKSON
KANAB, UT
NPI
1194505248
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: UT 10195848-2402)
Enumeration Date
2023-10-04
Last Update Date
2023-10-04
Business Address
BREANNA S JACKSON
355 N MAIN ST STE 103
KANAB, UT 84741-3260
Phone number: 435-644-4199
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Mailing Address
BREANNA S JACKSON
608 E CEDAR CIR
KANAB, UT 84741-3837
Phone number: 435-851-1283
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