Individual
EDWARD JOSEPH DOUBRAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4968 W 13400 S, HERRIMAN, UT 84096-6427
(801) 254-6135
(801) 254-7159
Mailing address
4968 W 13400 S, HERRIMAN, UT 84096-6427
(801) 254-6135
(801) 254-7159
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10774617
UT
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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