Jake Beede
Specialist/Technologist, Other in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1780224972
StatusActive
Last updated in NPPESJan 15, 2020
Details
- NPI
- 1780224972
- Entity type
- Individual (NPI-1)
- Name
- Jake Beede
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 15, 2020
- Certification date
- Jan 15, 2020
- Last updated
- Jan 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246Z00000X | Specialist/Technologist, Other | – | – | Yes |
Practice location
4444 S 700 E Ste 203Salt Lake City, UT 84107-3075
Phone 801-268-4887
Mailing address
4444 S 700 E Ste 203Salt Lake City, UT 84107
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