Individual
HAELLY KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1724 N 450 W, APT 208, PROVO, UT 84604-1480
(385) 241-6650
Mailing address
1724 N 450 W, APT 208, PROVO, UT 84604-1480
(385) 241-6650
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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