Healthcare Provider Details

I. General information

NPI: 1124419296
Provider Name (Legal Business Name): JASMER HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N 1375 W
CLINTON UT
84015-6731
US

IV. Provider business mailing address

2317 N HILL FIELD RD STE 103
LAYTON UT
84041-4782
US

V. Phone/Fax

Practice location:
  • Phone: 801-628-5256
  • Fax:
Mailing address:
  • Phone: 801-525-4645
  • Fax: 801-779-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DUSTIN CHASE JASMER
Title or Position: CEO
Credential: FNP
Phone: 801-628-5256