Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 88149007101 | UT |
NPI | 1043649494 |
---|---|
Provider Name | Jacob Schmutz |
First Address | Bountiful, UT 84010-1230 |
Second Address | Bountiful, UT 84010-1230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2013 |
Last Update Date | 06/11/2013 |