Individual
MR. TRAVIS LANCE KELNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
255 N 400 W, APT 3004, SALT LAKE CITY, UT 84103-1125
(623) 256-5659
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
12/29/2017
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