Individual
KATERINA M KATSANEVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
2079 S 1200 E, #S406, SALT LAKE CITY, UT 84105-3580
(801) 635-6015
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
183500000X
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6578587-1701
PHARMACIST LICENSURE
UT
01
—
RPH 025496
PHARMACIST LICENSURE
GA
Enumeration date
07/25/2013
Last updated
07/25/2013
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