Organization
JON W AHLSTROM MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON W AHLSTROM MD (OWNER)
(435) 753-1545
Entity
Organization
Contact information
Practice address
550 E 1400 N, STE I, NORTH LOGAN, UT 84341-2406
(435) 753-1545
(435) 753-3153
Mailing address
550 E 1400 N, STE I, NORTH LOGAN, UT 84341-2406
(435) 753-1545
(435) 753-3153
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4918766-1205
UT
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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