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Individual

MARK A. R. KRYSKOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
30 N 1900 E RM 3C344, SALT LAKE CITY, UT 84132-0002
(801) 585-1618
Mailing address
30 N 1900 E RM 3C344, SALT LAKE CITY, UT 84132-0002
(801) 585-1618

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
262547
MA
2086S0102X
Surgical Critical Care Physician
Primary
11634089-1204
UT

Other

Enumeration date
06/09/2015
Last updated
06/11/2020
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