NPI 1003417510

Jacob L Smith

Practitioner Pharmacist Salt Lake City, UT

Practice location

Address: 4627 S 900 E, Salt Lake City, UT 84117-4879
Phone: (801) 261-3818

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 6616817-1707 (UT)

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Registry record

NPI: 1003417510
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Nov 2020
Record last updated: 3 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.