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NPI 1770235574

NPI 1770235574 : DANIEL FELTCH : VERNAL, UT

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General NPI Number Information
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    NPI Number           |    1770235574
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    Entity Type          |    Individual 
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    Provider Name        |    DANIEL FELTCH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/22/2022
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    Last Update Date     |    01/22/2022
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Provider Practice Location Address
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    Address Line         |    1851 W HIGHWAY 40 
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    City                 |    VERNAL
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    State                |    UT
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    Zip                  |    84078-4125
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    Country              |    US
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    Telephone            |    435-789-9787
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    Fax                  |    435-789-1310
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Provider Business Mailing Address
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    Address Line         |    375 E 2900 S 
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    City                 |    VERNAL
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    State                |    UT
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    Zip                  |    84078-8857
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    Country              |    US
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    Telephone            |    801-358-4126
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    Fax                  |    
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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       |    8416100-1701
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    License Number State |    UT
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