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Individual

CORY ALAN CHRISTENSEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
245 W HIGHWAY 40, ROOSEVELT, UT 84066-3710
(435) 722-2454
(435) 722-4191
Mailing address
RR 3 BOX 3090, ROOSEVELT, UT 84066-9612
(435) 722-4954
(435) 722-4191

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
147117
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
870672738008
UT
Enumeration date
05/18/2006
Last updated
07/09/2007
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