MIKAELA SUE JORGENSEN

PROVO, UT
NPI1639944408
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: UT  13416952-4810)
Enumeration Date2023-11-21
Last Update Date2023-11-21
Business Address
MIKAELA SUE JORGENSEN MAT, LAT, ATC
150 E BULLDOG BLVD
PROVO, UT 84604-2676
Phone number: 801-422-4636
Mailing Address
MIKAELA SUE JORGENSEN MAT, LAT, ATC
14133 S ENSIGN PEAK CIR
RIVERTON, UT 84096-6415
Phone number: 801-819-8705
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