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1760602460
CARRIE MICHELLE JACKMAN
PROVO, UT
NPI
1760602460
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 6305663-1206)
Enumeration Date
2007-04-26
Last Update Date
2007-07-08
Business Address
Ms. CARRIE MICHELLE JACKMAN PA-C
5314 N 250 W SUITE 220
PROVO, UT 84604-5691
Phone number: 801-225-8484
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Mailing Address
Ms. CARRIE MICHELLE JACKMAN PA-C
962 S 830 E
OREM, UT 84097-4703
Phone number: 801-836-5873
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