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1740880111
RUSSELL LARSON
OGDEN, UT
NPI
1740880111
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: UT 7290041-1701)
Enumeration Date
2020-10-27
Last Update Date
2020-10-27
Business Address
RUSSELL LARSON
534 N HARRISVILLE RD
OGDEN, UT 84404-3532
Phone number: 801-737-0544
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Mailing Address
RUSSELL LARSON
534 N HARRISVILLE RD
OGDEN, UT 84404-3532
Phone number: 801-737-0544
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