Individual
DR. JEBADIAH CODY BLACKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
860 N FAIRFIELD RD, LAYTON, UT 84041-2725
(801) 546-6352
(801) 546-3754
Mailing address
611 KIMBALL DR, LAYTON, UT 84041-4210
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7640036-1701
UT
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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