Individual
MATTHEW BRYCE JOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1676 E 1300 S, SALT LAKE CITY, UT 84105-1704
(801) 582-1999
(801) 582-1270
Mailing address
1676 E 1300 S, SALT LAKE CITY, UT 84105-1704
(801) 582-1999
(801) 582-1270
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
12322305-1703
UT
3336C0004X
Compounding Pharmacy
12322305-1703
UT
Other
Enumeration date
07/15/2022
Last updated
07/27/2022
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