Individual
MATT AMIDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
290 S MAIN ST, MOAB, UT 84532-2596
(435) 313-2012
Mailing address
290 S MAIN ST, MOAB, UT 84532-2509
(435) 313-2012
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7550499-1701
UT
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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