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Jeff Lynn Penrose

Case Manager/Care Coordinator in Salt Lake City, UT. Individual provider (NPI-1).

NPI number1093554636
StatusActive
Last updated in NPPESMay 22, 2024

Details

NPI
1093554636
Entity type
Individual (NPI-1)
Name
Jeff Lynn Penrose
Sex
Male
Sole proprietor
Yes
Enumeration date
May 22, 2024
Certification date
May 22, 2024
Last updated
May 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator––Yes

Practice location

392 E 3900 S
Salt Lake City, UT 84107-1615

Phone 801-856-7799

Mailing address

392 E 3900 S
Salt Lake City, UT 84107-1615

Phone 801-856-7799

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