Individual
JOHNATHAN OTTO CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
350 N FREEDOM BLVD, PROVO, UT 84601-2810
(801) 377-9250
Mailing address
350 N FREEDOM BLVD, PROVO, UT 84601-2810
(801) 377-9250
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8071132-1701
UT
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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