| NPI | 1225135106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T COULDWELL De PT Chair 801-581-6909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-09-06 |