| NPI | 1508994955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY LOFTHOUSE Credentialing Specialist 435-631-9035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: UT 103460-0501) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2022-11-12 |