| NPI | 1427511336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROD BOWEN CEO 801-633-6696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology |
| Additional Taxonomies | 213ER0200X Podiatrist Radiology |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 225100000X Physical Therapist | |
| 207RS0010X Internal Medicine Sports Medicine | |
| 207Q00000X Family Medicine | |
| 207QS0010X Family Medicine Sports Medicine | |
| 207R00000X Internal Medicine | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 2085U0001X Radiology Diagnostic Ultrasound | |
| 2086S0129X Surgery Vascular Surgery | |
| 213E00000X Podiatrist | |
| 213EP1101X Podiatrist Primary Podiatric Medicine | |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2023-12-26 |