Jared Alton Jaccard, LMT
Massage Therapist in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1245035161
StatusActive
Last updated in NPPESFeb 14, 2025
Details
- NPI
- 1245035161
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jared Alton Jaccard
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 14, 2025
- Certification date
- Feb 11, 2025
- Last updated
- Feb 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 14070400-4701 | UT | Yes |
Practice location
1253 E Emelita StSalt Lake City, UT 84117-6536
Phone 801-842-9940
Mailing address
1253 E Emelita StSalt Lake City, UT 84117-6536
Phone 801-842-9940
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