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1700925070
GEORGE JOEL THACKER
PROVO, UT
NPI
1700925070
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: UT 6226993-1701)
Enumeration Date
2007-02-05
Last Update Date
2007-07-08
Business Address
MR. GEORGE JOEL THACKER PHARMD.
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-3843
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Mailing Address
MR. GEORGE JOEL THACKER PHARMD.
203 N 1200 W APT 101
OREM, UT 84057-4588
Phone number: 801-369-7434
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