Individual
CORY A LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
6949 HIGH TECH DR, MIDVALE, UT 84047-3705
(801) 233-6100
Mailing address
5117 W 8620 S, WEST JORDAN, UT 84088-3902
(801) 282-3990
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
316169-1701
UT
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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