Individual
SANDRA OMOTILEWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7463 S WOOD FARMS DR, WEST JORDAN, UT 84084-5556
(508) 801-9127
Mailing address
7463 S WOOD FARMS DR, WEST JORDAN, UT 84084-5556
(508) 801-9127
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
27595
NC
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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