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Individual

DR. JACOB CHASE FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
3435 E PONY EXPRESS PKWY STE 150, EAGLE MOUNTAIN, UT 84005
(801) 753-5100
(801) 753-5101
Mailing address
3435 E PONY EXPRESS PKWY STE 150, EAGLE MOUNTAIN, UT 84005
(801) 753-5100
(801) 753-5101

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6870402-1701
UT

Other

Enumeration date
10/20/2009
Last updated
07/12/2019
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