Healthcare Provider Details

I. General information

NPI: 1497609598
Provider Name (Legal Business Name): JACE ZEMCIK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1742 HAYES DR
LAYTON UT
84040-6800
US

IV. Provider business mailing address

1742 HAYES DR
LAYTON UT
84040-6800
US

V. Phone/Fax

Practice location:
  • Phone: 385-370-2191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number13072241-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: