Individual
MR. JERRY A SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.,M.B.A
Contact information
Practice address
1584 W 900 N, LEHI, UT 84043-5801
(801) 580-4509
Mailing address
1584 W 900 N, LEHI, UT 84043-5801
(801) 580-4509
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
151226-1701
UT
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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