Most Relevant Information
Provider Data
| NPI Number: | 1003417510 |
| Provider Name: | JACOB L SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 6616817-1707 |
Most Important Dates
| Enumeration Date: | 11/03/2020 |
| Last Updated: | 11/03/2020 |
Provider Practice Location
4627 S 900 E
SALT LAKE CITY
UT
841174879
Practice Location Phone/Fax
| Phone: | 8012613818 |
| Fax: |
Provider Mailing Location
4627 S 900 E
SALT LAKE CITY
UT
841174879
Provider Mailing Phone/Fax
| Phone: | 8012613818 |
| Fax: |