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NPI Code Detail

MEDICARE: JAMISON DOUGLAS LAW CPCI

MEDICARE:   JAMISON DOUGLAS LAW  CPCI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor56338026009UT

General Provider Information

NPI Number : 1699706168
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMISON DOUGLAS LAW CPCI
Provider Business Mailing Address
First Line : 3812 CHILTON CIRCLE
Second Line :
City : EAGLE MOUNTIAN
State : UT
Zip : 84005
Country : US
Telephone Number : 801-789-6023
Fax Number : 801-263-6370
Provider Business Practice Location Address
First Line : 32 W WINCHESTER ST
Second Line : SUITE 101
City : SALT LAKE CITY
State : UT
Zip : 84107-5607
Country : US
Telephone Number : 801-263-6367
Fax Number : 801-236-3670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 07/08/2007

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Directions to “ JAMISON DOUGLAS LAW CPCI” Practice Location

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