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1255445383
TANYA S JACKSON
SANDY, UT
NPI
1255445383
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: UT 518917351205)
Enumeration Date
2006-08-18
Last Update Date
2007-07-08
Business Address
-- TANYA S JACKSON MD
9500 S 1300 E
SANDY, UT 84094-3763
Phone number: 801-501-2100
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Mailing Address
-- TANYA S JACKSON MD
9500 S 1300 E
SANDY, UT 84094-3763
Phone number: 801-501-2100
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