Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Pm and R

Organization Physical Medicine & Rehabilitation Physician · NPI 1760776223

Pediatric Pm and R is a Physical Medicine & Rehabilitation Physician in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2011.

Licensed in
UT
In the registry since
2011
Specialties on file
2

Practice location Address checks out

100 Mario Capecchi Dr Rm 4400
Salt Lake City, UT 84113-1103
Phone: (801) 662-4949
Fax: (801) 662-4931
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Rehabilitation Medicine Physician (primary) Taxonomy 2081P0010X · Licence 72775361205 (UT)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 72775361205 (UT)

Record details

NPI number1760776223
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elie Elovic — Chair · (801) 662-4949
NPI enumeratedJune 1, 2011
Last updated in NPPESJune 1, 2011
Mailing addressPo Box 413032, Salt Lake City, UT 84141-3032

Other providers in Salt Lake City