Organization
SPINE & SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES BOVA MD (PRESIDENT)
(801) 261-1946
Entity
Organization
Contact information
Practice address
3336 PIONEER PKWY, #204, WEST VALLEY CITY, UT 84120-2000
(801) 261-1946
(801) 264-1138
Mailing address
1250 E 3900 S, #440, SLC, UT 84124-1348
(801) 261-1946
(801) 264-1138
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
1856991205
UT
Other
Enumeration date
04/20/2007
Last updated
08/22/2020
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