Individual
MR. CHRISTOPHER KENNETH CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 S 2000 E, SALT LAKE CITY, UT 84112-5820
(702) 810-2210
Mailing address
30 SOUTH 2000 EAST, SALT LAKE CITY, UT 84112
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
76990951702
UT
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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