| NPI | 1326057258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL I MADONNA Director Of Contracting And Pe 801-587-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck |
| 2082S0105X Plastic Surgery, Surgery of the Hand | |
| 2086S0102X Surgery, Surgical Critical Care | |
| 2086S0105X Surgery, Surgery of the Hand | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2009-04-14 |