| NPI | 1255466447 |
|---|---|
| Doing Business As | BOUNTIFUL COSMETIC DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 200631121) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2008-07-30 |