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1376253427
JAXAN ARCHIBALD
PRICE, UT
NPI
1376253427
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-11-30
Last Update Date
2022-11-30
Business Address
JAXAN ARCHIBALD
496 E 100 N
PRICE, UT 84501-2667
Phone number: 435-637-4320
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Mailing Address
JAXAN ARCHIBALD
PO BOX 867
PRICE, UT 84501-0867
Phone number:
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