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1598240947
JACOB LYLE HERETH
SALT LAKE CITY, UT
NPI
1598240947
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Additional Taxonomies
172V00000X Community Health Worker
Enumeration Date
2018-10-02
Last Update Date
2021-01-07
Business Address
JACOB LYLE HERETH
4460 S HIGHLAND DR STE 300
SALT LAKE CITY, UT 84124-3562
Phone number: 888-949-4864
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Mailing Address
JACOB LYLE HERETH
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
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