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General NPI Number Information
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NPI Number | 1336224914
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Entity Type | Individual
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Provider Name | W. JOHN COLES C.PH.T.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1580 W ANTELOPE DR STE 130A
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City | LAYTON
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State | UT
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Zip | 84041-1173
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Country | US
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Telephone | 801-525-5277
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Fax | 801-525-5279
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Provider Business Mailing Address
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Address Line | 5349 S 4100 W
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City | ROY
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State | UT
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Zip | 84067-7727
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Country | US
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Telephone | 801-985-1613
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Fax | 801-525-5279
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 5040990-1717
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License Number State | UT
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