Individual
KELSA LEE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4460 S HIGHLAND DR STE 210, SALT LAKE CITY, UT 84124-3550
(888) 949-4864
Mailing address
4460 S HIGHLAND DR STE 210, SALT LAKE CITY, UT 84124-3550
(888) 949-4864
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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