Individual
JEREMY KIM BURTENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
5450 S 2150 W, ROY, UT 84067-2155
(801) 678-2971
Mailing address
5450 S 2150 W, ROY, UT 84067-2155
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6651223-1701
UT
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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