JACOB CHURCH

PROVO, UT
NPI1598495855
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2022-06-10
Last Update Date2022-06-10
Business Address
JACOB CHURCH PA
1055 N 500 W STE 121
PROVO, UT 84604-3305
Phone number: 013-737-3508
Mailing Address
JACOB CHURCH PA
1055 N 500 W
PROVO, UT 84604-3305
Phone number: 801-354-8225
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