Individual
CHACE THOMAS ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6932 E. 1400 S., FORT DUCHESNE, UT 84026
(435) 725-6877
Mailing address
PO BOX 160, FORT DUCHESNE, UT 84026-0160
(435) 725-6877
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16119
NE
Other
Enumeration date
07/12/2018
Last updated
12/12/2022
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