Provider Demographics
NPI:1639478639
Name:SEEGMILLER, JON S (RPH)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:S
Last Name:SEEGMILLER
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 1:652 N 800 E
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1651
Mailing Address - Country:US
Mailing Address - Phone:801-798-9788
Mailing Address - Fax:801-798-2533
Practice Address - Street 1:652 N 800 E
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1651
Practice Address - Country:US
Practice Address - Phone:801-798-9788
Practice Address - Fax:801-798-2533
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT148264-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist