Individual
DR. CRYSTAL BRENNEN WALLENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1937 E SAINT MARYS DR, SLC, UT 84108-2245
(801) 865-0549
Mailing address
1937 E SAINT MARYS DR, SLC, UT 84108-2245
(801) 865-0549
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3613633-1205
UT
Other
Enumeration date
11/06/2008
Last updated
01/07/2023
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