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Individual

JACE BRIGHAM NIELSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1172 E 100 N STE 1, PAYSON, UT 84651-1668
(801) 465-4322
Mailing address
1172 E 100 N STE 1, PAYSON, UT 84651-1668

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9050300
UT

Other

Enumeration date
01/04/2021
Last updated
01/04/2021
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