Ut Center for Pain Management and Research, INC

NPI #1902805948 in Provo, Utah

Provider Information

NPI Number: 1902805948
Entity Type: Organization
Organization Name: Ut Center for Pain Management and Research, INC
Primary Specialty: Pain Medicine - Pain Medicine
Enumeration Date: Jul 20, 2005
Last Updated: Sep 30, 2014

Practice Location

Address: 3585 N UNIVERSITY AVE STE 150
City: Provo
State: Utah
ZIP Code: 84604-6630
Phone: (801) 356-6100

Authorized Official

Name: RICHARD M ROSENTHAL, M.D.
Title: MEDICAL DIRECTOR
Phone: (801) 356-6100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Medicine & Rehabilitation	208100000X
Psychologist	103T00000X
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X	Primary

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