NPI | 1649704032 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD SARCHENKO Physician 801-784-7104 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: UT 8547239-1202) |
Enumeration Date | 2017-04-12 |
Last Update Date | 2017-04-12 |