Individual
ALYSSA C PUTTKAMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5169 S COTTONWOOD ST STE 410, MURRAY, UT 84107-6769
(801) 507-1600
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(018) 507-1600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12830622-1206
UT
363A00000X
Physician Assistant
4636-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477016574
—
WI
Enumeration date
04/08/2019
Last updated
11/29/2022
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