| NPI | 1629775663 |
|---|---|
| Doing Business As | INNOVATION MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | TAYLOR G WRIGHT Authorized Official 801-266-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2024-02-06 |