NPI 1003256967
Jesse Judd-Dominguez
Practice location
- Address
- 1344 W State Rd, Pleasant Grove, UT 84062-5022
- Phone
- (801) 785-8870
Registered specialties
Community Health Worker
Primary
Registry record
- NPI
- 1003256967
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 25 Jun 2013
- Record last updated
- 25 Jun 2013
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.