Most Relevant Information
Provider Data
| NPI Number: | 1003060815 |
| Provider Name: | CRYSTAL BRENNEN WALLENTINE M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 3613633-1205 |
Most Important Dates
| Enumeration Date: | 11/06/2008 |
| Last Updated: | 01/07/2023 |
Provider Practice Location
1937 E SAINT MARYS DR
SLC
UT
841082245
Practice Location Phone/Fax
| Phone: | 8018650549 |
| Fax: |
Provider Mailing Location
1937 E SAINT MARYS DR
SLC
UT
841082245
Provider Mailing Phone/Fax
| Phone: | 8018650549 |
| Fax: |
Suggested EMR
Internist EMR