Organization
INTERMOUNTAIN HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DESAUTELS (OCCUPATIONAL THERAPIST)
(801) 662-4980
Entity
Organization
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-4980
Mailing address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
107520-4201
UT
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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