| NPI | 1891345237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WALKER Owner 801-913-8796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-17 |