Individual
PETA-GAYE KLENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
669 W 900 N, NORTH SALT LAKE, UT 84054-2602
(888) 222-2956
(866) 373-2979
Mailing address
669 W 900 N, NORTH SALT LAKE, UT 84054-2602
(888) 222-2956
(866) 373-2979
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6419590-1701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6419590-1701
PHARMACIST LICENSE
UT
Enumeration date
11/24/2015
Last updated
11/24/2015
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