Individual
KATHRYN MARIE ALFONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1157 N 300 W STE 201, PROVO, UT 84604-6124
(801) 357-1200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
14009205-1204
UT
208100000X
Physical Medicine & Rehabilitation Physician
2021-02218
NC
208100000X
Physical Medicine & Rehabilitation Physician
64047
MN
Other
Enumeration date
04/17/2017
Last updated
03/06/2026
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