| NPI | 1962805358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI SCOTT Assistant Ad Finance 801-863-8819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine Sports Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2021-02-19 |