| NPI | 1942580162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWNA H GOULDING Office Administrator 801-409-2044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: UT 6414842-1204) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2011-08-18 |