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1306312202
JENNA CROCKETT
SALT LAKE CITY, UT
NPI
1306312202
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Former Name
JENNA PANG-CHING
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: UT 00000)
Enumeration Date
2018-10-17
Last Update Date
2018-10-17
Business Address
JENNA CROCKETT
375 S CHIPETA WAY STE A
SALT LAKE CITY, UT 84108-1261
Phone number: 808-640-7029
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Mailing Address
JENNA CROCKETT
375 S CHIPETA WAY STE A
SALT LAKE CITY, UT 84108-1261
Phone number:
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