Pediatric Pm and R
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 4400Salt Lake City, UT 84113-1103
Phone: (801) 662-4949
Fax: (801) 662-4931
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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 number | 1760776223 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Elie Elovic — Chair · (801) 662-4949 |
| NPI enumerated | June 1, 2011 |
| Last updated in NPPES | June 1, 2011 |
| Mailing address | Po Box 413032, Salt Lake City, UT 84141-3032 |
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