Provider Demographics
NPI:1144778168
Name:DRATTER, JOSEPH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:DRATTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1587 E GLEN ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3800
Mailing Address - Country:US
Mailing Address - Phone:913-481-2241
Mailing Address - Fax:
Practice Address - Street 1:4714 S HOLLADAY BLVD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-5403
Practice Address - Country:US
Practice Address - Phone:801-278-9767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7692095-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist