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Individual
CLAYTON JAMES GRACE
Active
Individual
CLAYTON JAMES GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
349338-1701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
349338-1701
PHARMACIST
UT
01
—
349338-8911
PHARMACIST CONTROLLED SUB
UT
Enumeration date
04/25/2007
Last updated
07/08/2007
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