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1699270413
JACKSON WONG
SALT LAKE CITY, UT
NPI
1699270413
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: UT 11416306-1205)
Enumeration Date
2018-03-25
Last Update Date
2019-09-17
Business Address
JACKSON WONG MD
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108-1222
Phone number: 801-581-4096
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Mailing Address
JACKSON WONG MD
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108-1222
Phone number: 801-581-4096
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