| NPI | 1689788762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL SCOTT WAHLEN President 801-337-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 58673691205) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: UT 346009-1202) |
| 111N00000X Chiropractor (Licence: UT 273153-1202) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: UT 537865-1205) | |
| 363L00000X Nurse Practitioner (Licence: UT 347196-4405) | |
| 363L00000X Nurse Practitioner (Licence: UT 223876-4405) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 77062171205) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2012-05-24 |