Individual
TARA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4040 W 5415 S, SALT LAKE CITY, UT 84118-4308
(801) 982-1912
Mailing address
3706 BRYCE CANYON DR, RIVERTON, UT 84065-6735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6109331-1701
UT
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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