| NPI | 1518115419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REED FOGG Owner 801-314-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 147576-1205) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-09-10 |