Individual
ALYSA ALBERTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 E 1300 S STE 103, SALT LAKE CITY, UT 84115-6118
(385) 212-2934
Mailing address
145 E 1300 S STE 103, SALT LAKE CITY, UT 84115-6118
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6565348-1701
UT
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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