Provider Demographics
NPI:1780225219
Name:GRAFF, JEFF (RPH)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:GRAFF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 S 1650 E
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-5774
Mailing Address - Country:US
Mailing Address - Phone:801-874-5277
Mailing Address - Fax:
Practice Address - Street 1:632 S 100 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2864
Practice Address - Country:US
Practice Address - Phone:801-465-2591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-06
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT152930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist