Individual
KURT KYLE LANDENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSS
Contact information
Practice address
2200 S STATE ST FL 2, SALT LAKE CITY, UT 84115-2724
(801) 359-8862
(801) 359-8510
Mailing address
2200 S STATE ST FL 2, SALT LAKE CITY, UT 84115-2724
(801) 359-8862
(801) 359-8510
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
UT
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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