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Jayme Foster Lott
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NPI Number Detailed Information
Provider Information:
Name: | Jayme Foster Lott |
Gender: | M |
Provider License Number If Given: | 6183824-1206 |
NPI Information:
NPI: | 1619970647 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 5/23/2005 |
Last Update Date: | 11/13/2018 |
Provider Business Mailing Address:
Address: | 1055 N 500 W ATTN: CREDENTIALING Provo, UT 84604 |
Phone Number: | 8013548225 |
Fax Number: | 8014180941 |
Provider Business Practice Location Address:
Address: | 736 S 900 E STE 203 St George, UT 84790 |
Phone Number: | 4356736131 |
Fax Number: | 4356738557 |
Provider Taxonomy:
Primary: | 363A00000X |
Secondary (if any): | 363A00000X |
State: | UT |