Individual
JACKIE TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3270 S 1300 E, SLC, UT 84106-3099
(801) 487-5461
Mailing address
3270 S 1300 E, SLC, UT 84106-3099
(801) 487-5461
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6346089
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6346089
DOPL
UT
Enumeration date
08/06/2022
Last updated
08/06/2022
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