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Individual

NICOLE URESK GLINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
250 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-6123
Mailing address
292 PARK PL, ROOSEVELT, UT 84066-2669

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6447858-1701
UT
183500000X
Pharmacist
6447858-8911
UT

Other

Enumeration date
04/05/2017
Last updated
04/05/2017
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