Individual
DR. KENNETH CONRAD JACKSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D., R.PH.
Contact information
Practice address
546 CHIPETA WAY, SUITE 220, SALT LAKE CITY, UT 84108-1236
(801) 581-7246
(801) 581-6243
Mailing address
2731 HARTFORD ST, SALT LAKE CITY, UT 84106-3652
(801) 487-2169
(801) 581-6243
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
363584-1701
UT
Other
Enumeration date
11/09/2005
Last updated
09/11/2025
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