| NPI | 1477812949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID B GLOVER Manager 801-479-7505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: UT 3704370501) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2012-09-14 |