Individual
JACOB LUIS GOUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
669 W 900 N, NORTH SALT LAKE, UT 84054-2602
(888) 222-2956
Mailing address
120 N VILLAGE WAY, FRUIT HEIGHTS, UT 84037-2178
(801) 647-3604
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6661108-1701
UT
Other
Enumeration date
02/28/2021
Last updated
02/28/2021
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