| NPI | 1922136126 |
|---|---|
| Doing Business As | INTERMOUNTAIN REDROCK PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 00009023) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: UT 00009023) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: UT 00009023) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2008-07-30 |