Most Relevant Information
Provider Data
| NPI Number: | 1003457011 |
| Provider Name: | JOHNATHAN OTTO CARTER PHARMACIST |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 8071132-1701 |
Most Important Dates
| Enumeration Date: | 10/01/2019 |
| Last Updated: | 10/01/2019 |
Provider Practice Location
350 N FREEDOM BLVD
PROVO
UT
846012810
Practice Location Phone/Fax
| Phone: | 8013779250 |
| Fax: |
Provider Mailing Location
350 N FREEDOM BLVD
PROVO
UT
846012810
Provider Mailing Phone/Fax
| Phone: | 8013779250 |
| Fax: |