Individual
DR. MATTHEW ALTON FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11328 S JORDAN GTWY, SOUTH JORDAN, UT 84095-4112
(801) 553-2270
Mailing address
11328 S JORDAN GTWY, SOUTH JORDAN, UT 84095-4112
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6862534
UT
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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