Individual
DR. MICHAEL BLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
1770 W 4100 S, SALT LAKE CITY, UT 84119-4750
(801) 977-0294
(801) 747-1550
Mailing address
1770 W 4100 S, SALT LAKE CITY, UT 84119
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
17569
NV
183500000X
Pharmacist
4920123-1701
UT
183500000X
Pharmacist
Primary
RP00006710
NM
Other
Enumeration date
02/25/2010
Last updated
02/25/2010
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