Dominic Derose JR.

NPI #1083698559 in Clearfield, Utah

Provider Information

NPI Number: 1083698559
Entity Type: Individual
Name: Dominic Derose JR.
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Pharmacist
Enumeration Date: Nov 30, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 1080 W 300 N
City: Clearfield
State: Utah
ZIP Code: 84015-8732
Phone: (801) 773-7330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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