Organization
ELITE ORTHOPEDIC SURGERY AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW POULSEN (OWNER)
(801) 252-4888
Entity
Organization
Contact information
Practice address
980 E 800 N STE 104, OREM, UT 84097-4261
(801) 252-4888
(801) 252-4887
Mailing address
PO BOX 1169, BOUNTIFUL, UT 84011-1169
(801) 252-4888
(801) 252-4887
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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