| NPI | 1881143444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID WOOD Managing Member 801-285-0181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: UT 81002311710) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |