Provider Demographics
NPI:1396767679
Name:SONDRUP, TODD L (RPH)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:L
Last Name:SONDRUP
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 1:1369 S 900 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2301
Mailing Address - Country:US
Mailing Address - Phone:801-599-0411
Mailing Address - Fax:
Practice Address - Street 1:1060 E 100 S
Practice Address - Street 2:SUITE L2
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1675
Practice Address - Country:US
Practice Address - Phone:801-539-0231
Practice Address - Fax:801-539-0350
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT131307-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist