Pediatric Urology Associates

NPI #1790794576 in Salt Lake City, Utah

Provider Information

NPI Number
1790794576
Entity Type
Organization
Organization Name
Pediatric Urology Associates
Primary Specialty
Urology
Enumeration Date
Aug 7, 2006
Last Updated
Apr 14, 2009

Practice Location

Address
100 MARIO CAPECCHI DR
State
Utah
ZIP Code
84113-1103
Phone
(801) 588-2000

Authorized Official

Name
JANELL I MADONNA
Title
DIRECTOR OF CONTRACTING AND PE
Phone
(801) 587-6464

Specialties & Taxonomy Codes

Specialty
Urology

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