Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 8005885-1205 | UT |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 8005885-1205 | UT |
NPI | 1336396340 |
---|---|
Provider Name | Dr. Todd Ryan Grunander |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Ogden, UT 84403-3271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2008 |
Last Update Date | 25/07/2012 |