Individual
TAYLOR GLENN PAVELKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
755 E 2450 N, NORTH OGDEN, UT 84414-2972
(406) 215-5158
Mailing address
755 E 2450 N, NORTH OGDEN, UT 84414-2972
(406) 215-5158
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
14267269-1717
UT
183700000X
Pharmacy Technician
PHA-PTE-LIC-74010
MT
Other
Enumeration date
08/07/2026
Last updated
08/07/2026
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