Individual
SIUEA PETE KUPU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3571 S HIGHLANDER ST, SALT LAKE CITY, UT 84128-2317
(801) 891-1768
Mailing address
3571 S HIGHLANDER ST, SALT LAKE CITY, UT 84128-2317
(801) 891-1768
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17350-1701
UT
Other
Enumeration date
06/01/2013
Last updated
06/01/2013
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