Individual
DR. AMANDA K LARAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD.
Contact information
Practice address
5554 S 1900 W, ROY, UT 84067-2911
(801) 614-1263
Mailing address
2480 COMBE RD, OGDEN, UT 84403-5043
(801) 475-5327
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5300626-1701
UT
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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