| NPI | 1558676957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TY BOLTON ERICKSON M.D 801-727-2672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 63886701205) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2011-10-05 |