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General NPI Number Information
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NPI Number | 1285852392
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Entity Type | Individual
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Provider Name | ALICIA KIM GARDINER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1159 E 200 NO STE 125
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City | AMERICAN FORK
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State | UT
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Zip | 84003
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Country | US
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Telephone | 801-855-2935
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Fax | 801-855-2938
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Provider Business Mailing Address
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Address Line | 1229 NO 70 EAST
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City | AMERICAN FORK
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State | UT
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Zip | 84003
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Country | US
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Telephone | 801-492-1241
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Fax | 801-855-2938
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2755461701
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License Number State | UT
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