Individual provider · NPI-1

Alysa Albertine

Pharmacist · Salt Lake City, UT

NPI number1447879390
StatusActive
Last updated in NPPESApr 10, 2020

Details

NPI
1447879390
Entity type
Individual (NPI-1)
Name
Alysa Albertine
Sex
Female
Sole proprietor
No
Enumeration date
Apr 10, 2020
Certification date
Apr 10, 2020
Last updated
Apr 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist6565348-1701UTYes

Practice location

145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118

Phone 385-212-2934

Mailing address

145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118

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