Organization
WASATCH PHYSICAL AND REHABILITATION MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY R MELVILLE M.D. (OWNER)
(801) 732-5900
Entity
Organization
Contact information
Practice address
4403 HARRISON BLVD STE 1875, OGDEN, UT 84403-3325
(801) 732-5900
(801) 732-5989
Mailing address
4403 HARRISON BLVD STE 1875, OGDEN, UT 84403-3325
(801) 732-5900
(801) 732-7989
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400823741000
—
UT
Enumeration date
03/04/2008
Last updated
06/24/2016
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