NPI 1174669949

Matthew Vandenberg, CPHT

Practitioner Pharmacy Technician Salt Lake City, UT

Practice location

Address: 500 Foothill Blvd, Salt Lake City, UT 84148-0001
Phone: (801) 582-1565
Mailing address: 4158 Berridale Cir, South Jordan, UT 84095-9102

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X

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Registry record

NPI: 1174669949
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jan 2007
Record last updated: 8 Jul 2007

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.