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Individual

MR. CHARLES R WILLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
5353 W 11000 N, HIGHLAND, UT 84003-9403
(801) 756-8353
(801) 756-3525
Mailing address
134 W 2225 N, LEHI, UT 84043-2835
(801) 768-8926

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
144363-1701
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
870309253012
UT
Enumeration date
07/25/2006
Last updated
07/09/2007
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