| NPI | 1760776223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIE P ELOVIC Chair 801-662-4949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: UT 72775361205) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 72775361205) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |