| NPI | 1841687126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS MCCHESNEY Office Manager 801-815-8019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: UT 9451461-1704) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2023-10-23 |