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1063303717
SHELLY JO WAHLSTROM
ROY, UT
NPI
1063303717
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
374K00000X Religious Nonmedical Practitioner
(Licence: AZ 374K00000X)
Enumeration Date
2025-07-11
Last Update Date
2025-07-11
Business Address
SHELLY JO WAHLSTROM CHT, PHD
2827 W 4400 S
ROY, UT 84067-8951
Phone number: 801-643-3211
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Mailing Address
SHELLY JO WAHLSTROM CHT, PHD
2827 W 4400 S
ROY, UT 84067-8951
Phone number: 801-643-3211
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