Jackie Anne Fonua, PA-C
NPI #1336227206 in West Jordan, Utah
Provider Information
- NPI Number
- 1336227206
- Entity Type
- Individual
- Name
- Jackie Anne Fonua, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine
- Credential
- PA-C
- Enumeration Date
- Nov 1, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 3354 W 7800 S
- City
- West Jordan
- State
- Utah
- ZIP Code
- 84088-4506
- Phone
- (801) 282-2677
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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