Individual
STEWART S. KOEVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
1901 BERKELEY ST, SALT LAKE CITY, UT 84108-3201
(801) 487-4050
Mailing address
1901 BERKELEY, SALT LAKE CITY, UT 89108
(801) 487-4050
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
148212-1701
UT
Other
Enumeration date
12/19/2008
Last updated
12/19/2008
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