Provider Demographics
NPI:1306430525
Name:CRESSALL, MARCUS (PHARMD)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:CRESSALL
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 1:1387 W 1850 N
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-2827
Mailing Address - Country:US
Mailing Address - Phone:801-745-5188
Mailing Address - Fax:
Practice Address - Street 1:1407 N 2000 W STE E
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:UT
Practice Address - Zip Code:84015-8563
Practice Address - Country:US
Practice Address - Phone:801-745-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7290318-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist