Individual
CODY RANDALL WARDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
284 E REGENT PARK CT, MIDVALE, UT 84047-2728
(973) 765-4864
Mailing address
284 E REGENT PARK CT, MIDVALE, UT 84047-2728
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5109182-1701
UT
Other
Enumeration date
10/19/2020
Last updated
09/21/2021
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