Individual
JUSTIN BRENT TUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1632 N 2000 W, CLINTON, UT 84015-8367
(801) 779-3326
Mailing address
1308 W 2000 S, SYRACUSE, UT 84075-8408
(801) 425-3364
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7164946-1701
UT
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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