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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 |
