| NPI | 1447455167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L NELSON Owner 801-794-3856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: UT 367775-0501) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-05-20 |