Individual
MARILOU MINER KRSTYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
573 W 100 N, BOUNTIFUL, UT 84010-7018
(801) 299-3968
(801) 299-3965
Mailing address
3242 FORTUNA DR, SALT LAKE CITY, UT 84124-5614
(801) 273-0851
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
147673-1701
UT
Other
Enumeration date
03/12/2012
Last updated
03/12/2012
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