Individual
MCKAYLA POULSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3250 S 700 E, SALT LAKE CITY, UT 84106-1641
(801) 467-0152
Mailing address
1259 E LORI CIR, SANDY, UT 84094-1915
(801) 815-5733
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9051498-1701
UT
Other
Enumeration date
09/26/2020
Last updated
09/26/2020
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