| NPI | 1508875857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL I MADONNA Director Of Contracting And Pe 801-587-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology |
| 231H00000X Audiologist | |
| 231HA2400X Audiologist Assistive Technology Practitioner | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2009-04-14 |