Individual
CLINT C IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
608 W MAIN ST, AMERICAN FORK, UT 84003-9762
(801) 756-5997
Mailing address
608 W MAIN ST, AMERICAN FORK, UT 84003-9762
(801) 756-5997
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7362710-1701
UT
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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