JACKIE MELVILLE HUDSON

SALT LAKE CITY, UT
NPI1871392571
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2025-03-13
Last Update Date2025-03-13
Business Address
JACKIE MELVILLE HUDSON
117 W 400 S
SALT LAKE CITY, UT 84101-1916
Phone number: 801-428-4257
Mailing Address
JACKIE MELVILLE HUDSON
117 W 400 S
SALT LAKE CITY, UT 84101-1916
Phone number: 801-428-4257