Individual
MICHAEL JOHN KATZOURAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
1088 CRESTVIEW CIR, SALT LAKE CITY, UT 84108-2007
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6573975-1702
UT
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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