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Individual

TREVOR SOUTHWICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2228 W 1700 S, SYRACUSE, UT 84075
(801) 775-9880
Mailing address
1355 W 25 N, CLEARFIELD, UT 84015
(801) 837-1821

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7619529-1701
UT

Other

Enumeration date
07/29/2017
Last updated
07/29/2017
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