| NPI | 1639815483 |
|---|---|
| Doing Business As | UTAH WOUND CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | KRISTYN DICE Credentialing Manager 209-587-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-10-07 |