Individual
DEVAN ANDREW LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
763 N STATE ST, OREM, UT 84057-3807
(801) 734-1624
(801) 734-1627
Mailing address
763 N STATE ST, OREM, UT 84057-3807
(801) 734-1624
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9523307-1701
UT
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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