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Individual

GRANT E SEVERE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
175 E 442 N, LOGAN, UT 84321
(435) 753-6570
(435) 750-0931
Mailing address
9 S 490 E, SMITHFIELD, UT 84335-1221
(435) 764-1559

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
147190
UT

Other

Enumeration date
10/11/2019
Last updated
10/11/2019
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