Individual
ALISA JORGENSEN STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4190 HIGHLAND DR STE 250, SLC, UT 84124-2781
(877) 879-0722
Mailing address
900 VILLAGE BEND LN, MIDVALE, UT 84047-5685
(801) 214-5567
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4822083-8911
UT
Other
Enumeration date
12/10/2009
Last updated
12/10/2009
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