| NPI | 1609144989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER LEWIS COLLINS Podiatrist 801-273-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: UT 105502-0501) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |