| NPI | 1104060714 |
|---|---|
| Doing Business As | THE SPINE, ORTHOPEDIC AND PAIN CENTER |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY GRANGE Owner 801-955-1232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: UT 89180152-1205) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-07-06 |