NPI | 1033630918 |
---|---|
Entity Type | Organization |
Authorized Contact | CODY KIM HANSEN Owner/Pharmacist In Charge 435-674-0201 |
Organization Subpart ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: UT 5725931-1701) |
Enumeration Date | 2017-06-30 |
Last Update Date | 2022-07-21 |