| NPI | 1235421785 |
|---|---|
| Doing Business As | PARK CITY SPINE AND PAIN |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: UT 5842011) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |