| NPI | 1184119380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETEL KAY CRISON Podiatrist 801-839-8337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: UT 95-2954480501) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2024-01-21 |