| NPI | 1306029715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDT RYAN GIBSON President/Owner 801-756-0765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 5093909-0501) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2021-12-08 |