Individual
KEYHAN KOOHGIVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2566 EAST SAGE WAY, SALT LAKE CITY, UT 84109
(801) 557-3889
Mailing address
2566 EAST SAGE WAY, SALT LAKE CITY, UT 84109
(801) 557-3889
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
131944-1701
UT
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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