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Individual

MICHELE DANENE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
2400 N WASHINGTON BLVD, OGDEN, UT 84414-7233
(801) 786-7600
Mailing address
1967 E 6200 S, OGDEN, UT 84403-5274
(801) 475-9190

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
152542-1701
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
152542-1701
DOPL PHARMACIST LICENSE
UT
01
152542-8911
DOPL PHARMACIST CONTROLLED SUBSTANCE
UT
Enumeration date
05/19/2010
Last updated
05/19/2010
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