| NPI | 1821458878 |
|---|---|
| Doing Business As | INTERMOUNTAIN SPINE INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | REED EUGENE FOGG Director 801-314-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |