Chrystal Bennett Jackson

NPI #1003262338 in Riverton, Utah

Provider Information

NPI Number: 1003262338
Entity Type: Individual
Name: Chrystal Bennett Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: May 5, 2016
Last Updated: May 5, 2016

Practice Location

Address: 13923 S HAYSTACK PEAK CIR
City: Riverton
State: Utah
ZIP Code: 84096-6453
Phone: (801) 506-6695

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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