NPI 1558588475

Spine & Sports Medicine

Organisation Pain Medicine Physician West Valley City, UT

Practice location

Address: 3336 Pioneer Pkwy #204, West Valley City, UT 84120-2000
Phone: (801) 261-1946
Fax: (801) 264-1138
Mailing address: 1250 E 3900 S #440, Slc, UT 84124-1348

Authorised official

Name: Charles Bova
Title: President
Phone: (801) 261-1946

Registered specialties

Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0000X Licence 1856991205 (UT)

Other Pain Medicine providers in Utah →

Registry record

NPI: 1558588475
Entity type: Organization
NPI issued: 20 Apr 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.