Individual
KELLIE G ALFARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132
(801) 587-2267
Mailing address
801 N 29TH ST, BILLINGS, MT 59101-0905
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
55282
CA
Other
Enumeration date
01/12/2018
Last updated
01/13/2022
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