Graduated: 1987
NPI: 1316075344
Practice Locations (3)
9186 S JENNY LAKE DR
West Jordan, UT 840886343
8545 S REDWOOD RD, UNIT B
WEST JORDAN, UT 840885576
8017482192
9186 S JENNY LAKE DR
WEST JORDAN, UT 840886343
Source: CMS National Downloadable File, September 2026.