Individual
KRYSTAL AHLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
544 E WILMINGTON AVE, SALT LAKE CITY, UT 84106-1419
(801) 231-3038
Mailing address
544 E WILMINGTON AVE, SALT LAKE CITY, UT 84106-1419
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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