| NPI | 1700022621 |
|---|---|
| Doing Business As | BEAR RIVER SPEICIALISTS - MALAD |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 9062008) |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2008-12-23 |