Individual
DR. ALISA ANN KNOWLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
390 N MAIN ST, BOUNTIFUL, UT 84010-6046
(801) 294-1020
(801) 292-8369
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 294-1020
(801) 292-8369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3615541205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
942854057086
—
UT
Enumeration date
05/24/2006
Last updated
06/26/2009
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