Individual
DR. NATHANIEL ROY BALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1356 E HIGHWAY 193, LAYTON, UT 84040-8533
(801) 771-2994
(801) 771-2996
Mailing address
1356 E HIGHWAY 193, LAYTON, UT 84040-8533
(801) 771-2994
(801) 771-2996
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0021737
CO
183500000X
Pharmacist
Primary
7430082
UT
183500000X
Pharmacist
P8372
ID
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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