Individual
NATHAN BLACKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5126 W DAYBREAK PKWY, SOUTH JORDAN, UT 84095-5994
(801) 213-4550
Mailing address
5126 W DAYBREAK PKWY, SOUTH JORDAN, UT 84095-5994
(801) 213-4550
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6607216
UT
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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