DERICK JENSEN

SLC, UT
NPI1659794402
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2014-01-30
Last Update Date2014-01-30
Business Address
-- DERICK JENSEN
68 S 600 E
SLC, UT 84102-1007
Phone number: 801-322-1001
Mailing Address
-- DERICK JENSEN
5410 W 13680 S
HERRIMAN, UT 84096-1710
Phone number: 801-322-1001
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