Individual
DR. KYLE L WAHLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 SMITH AVE N, SAINT PAUL, MN 55102-2393
(952) 843-4333
(952) 843-4301
Mailing address
310 SMITH AVE N, SAINT PAUL, MN 55102-2383
(952) 843-4333
(952) 843-4301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
39709
MN
Other
Enumeration date
02/20/2006
Last updated
07/08/2007
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