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1881005064
JACOB TENGELSEN
PROVO, UT
NPI
1881005064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2014-05-09
Last Update Date
2014-05-09
Business Address
-- JACOB TENGELSEN
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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Mailing Address
-- JACOB TENGELSEN
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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