Ditlev Aste, Lisa

Ditlev Aste, Lisa is an individual health care provider with primary practice located at 1300 E Center St , Provo UT 84606-3554. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Chiropractic Providers / Internist. Chiropractic Providers / Internist is her primary health care specialty. Ditlev Aste, Lisa can be contacted via phone (801) 344-4411.

Contact Information

Primary practice address
1300 E Center St Provo UT 84606-3554
Fax: (801) 344-4225
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 180143 1205 Utah
Chiropractic Providers / Internist 111NI0900X 1801431205 Utah

Profile Details

NPI number 1225205941
LBN Legal business name Ditlev Aste, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2008
Last updated May 23rd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225205941 NPPES
Utah MEDICAID 09606

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