Individual
WADE OLIVER MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
1080 W HWY 40, VERNAL, UT 84078
(435) 789-7235
Mailing address
432 W 1070 S, VERNAL, UT 84078-4770
(435) 789-0250
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4907684-1701
UT
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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