Individual
JACOB B NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
555 E 1400 N, LOGAN, UT 84341-2453
(435) 750-0258
Mailing address
555 E 1400 N, LOGAN, UT 84341-2453
(435) 750-0258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7161285-1701
UT
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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