| NPI | 1245524651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL MADONNA Contracting Director 801-587-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: UT 3176341205) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-09-06 |