| NPI | 1063721850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYSHELLE HUBERT Practice Manager 801-750-8210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2010-11-18 |