Individual
DR. LISA DITLEV ASTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4411
(801) 344-4225
Mailing address
PO BOX 270, PROVO, UT 84603-0270
(801) 344-4411
(801) 344-4225
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
1801431205
UT
208D00000X
General Practice Physician
180143 1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09606
—
UT
Enumeration date
05/12/2008
Last updated
05/23/2008
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