| NPI | 1255844015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L CHILD Physician 801-766-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2020-04-01 |