| NPI | 1215313283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE B. FEOLA President/Medical Director 801-292-1464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 351671-1205) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2023-03-07 |