| NPI | 1144909672 |
|---|---|
| Doing Business As | BLACK STONE HEALTH |
| Doing Business As | BLACK STONE PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JOSH LEDER Administrator/CEO 801-641-5613 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 261Q00000X | |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-09-21 |