Organization
PEDIATRIC INPATIENT SERVICES RIVERTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE A DONE (MANAGER, PROVIDER ENROLLMENT)
(801) 285-4000
Entity
Organization
Contact information
Practice address
3741 W 126000 S, RIVERTON, UT 84065
(801) 285-4000
Mailing address
PO BOX 413021, SALT LAKE CITY, UT 84141-3021
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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