NPI | 1104324904 |
---|---|
Entity Type | Organization |
Authorized Contact | CAMERON G PETERSON Chief Medical Officer, Managing Par 801-598-8337 |
Organization Subpart ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2018-01-26 |
Last Update Date | 2019-03-14 |