Individual
KRISTINE EMANUELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
280 RIVER PARK DR, SUITE 240, PROVO, UT 84604-5764
(801) 615-1047
Mailing address
3738 LITTLE ROCK LN, PROVO, UT 84604-5310
(801) 615-1047
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
174H00000X
Health Educator
217972-4701
UT
225700000X
Massage Therapist
Primary
217972-4701
UT
Other
Enumeration date
12/18/2015
Last updated
01/05/2016
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