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1710037213
JEAN STANFORD
OREM, UT
NPI
1710037213
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: UT 102228-1206)
Enumeration Date
2007-01-10
Last Update Date
2011-10-18
Business Address
-- JEAN STANFORD PA-C
412 W 800 N
OREM, UT 84057-3728
Phone number: 801-235-7246
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Mailing Address
-- JEAN STANFORD PA-C
283 E 930 S
OREM, UT 84058-5001
Phone number: 801-225-6246
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