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Individual
KELLY DAHLSTROM
Active
Individual
KELLY DAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
11262272-1204
UT
2085R0202X
Diagnostic Radiology Physician
11262272-1204
UT
Other
Enumeration date
06/16/2014
Last updated
05/05/2020
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