Individual
DEANNA RAE MOULTRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1268 N 225 W, CENTERVILLE, UT 84014-1104
(801) 547-7976
Mailing address
1268 N 225 W, CENTERVILLE, UT 84014-1104
(801) 547-7976
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7457723-1701
UT
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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