NPI | 1114057924 |
---|---|
Doing Business As | SPORTS MEDICINE SPECIALISTS - BOUNTIFUL |
Entity Type | Organization |
Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
Organization Subpart ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: UT 2006-32348) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2009-08-27 |