Individual
MR. DELBERT GARY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
6822 EAST 1000 SOUTH, FORT DUCHESNE, UT 84026
(435) 725-6874
Mailing address
6822 EAST 1000 SOUTH, FORT DUCHESNE, UT 84026
(435) 725-6874
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
341687-1701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700000000009
—
UT
Enumeration date
08/17/2006
Last updated
04/05/2013
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