Organization
INTERMOUNTAIN SPINE PARTNERS
Active
Other names
Intermountain Spine Institute
Organization subpart
No
Provider details
NPI number
Authorized official
REED EUGENE FOGG M.D. (DIRECTOR)
(801) 314-2225
Entity
Organization
Contact information
Practice address
5770 SOUTH 250 EAST, SUITE 135, SALT LAKE CITY, UT 84107-8241
(801) 314-2225
(801) 314-2345
Mailing address
5770 SOUTH 250 EAST, SUITE 135, SALT LAKE CITY, UT 84107-8241
(801) 314-2225
(801) 314-2345
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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