Pediatric Urology Associates
Urology in Salt Lake City, UT. Organization (NPI-2).
NPI number1790794576
StatusActive
Last updated in NPPESApr 14, 2009
Details
- NPI
- 1790794576
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Urology Associates
- Organization subpart
- No
- Enumeration date
- Aug 7, 2006
- Last updated
- Apr 14, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | – | – | Yes |
Practice location
100 Mario Capecchi DrSalt Lake City, UT 84113-1103
Phone 801-588-2000
Mailing address
Po Box 413035Salt Lake City, UT 84141-0001
Phone 801-213-3800
Authorized official
Janell I Madonna
Director Of Contracting And Pe
8015876464
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