Provider Demographics
NPI:1932893088
Name:CRANE, GARRETT (RPH)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:CRANE
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 1:874 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:UT
Mailing Address - Zip Code:84664-5614
Mailing Address - Country:US
Mailing Address - Phone:801-380-4436
Mailing Address - Fax:
Practice Address - Street 1:420 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-2251
Practice Address - Country:US
Practice Address - Phone:801-853-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5033658-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist