CHARLIE R JACQUES

ST GEORGE, UT
NPI1336162890
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: UT  1976944405)
Enumeration Date2006-07-25
Last Update Date2008-06-26
Business Address
-- CHARLIE R JACQUES APRN
1380 E MEDICAL CENTER DR SUITE #1400
ST GEORGE, UT 84790-2123
Phone number: 435-251-2600
Mailing Address
-- CHARLIE R JACQUES APRN
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 435-251-2600
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