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Individual

LAFAYE BERGMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
4526 S 5120 W, WEST VALLEY, UT 84120-5620
(801) 969-5527
Mailing address
4526 S 5120 W, WEST VALLEY, UT 84120-5620
(801) 969-5527

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
3746191701
UT

Other

Enumeration date
07/13/2022
Last updated
07/13/2022
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