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Wasatch Pediatrics, Inc Authorization for Disclosure of Health Information Patient Name: Date of Birth: Phone #: Address: City: State: Zip: I authorize the use or disclosure of the above named individuals
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Wasatch Pediatrics Inc is a pediatric medical practice located in Utah.
Wasatch Pediatrics Inc is required to file its annual report with the state of Utah.
Wasatch Pediatrics Inc must complete and submit the necessary forms provided by the state of Utah.
The purpose of Wasatch Pediatrics Inc is to provide pediatric medical care to its patients.
Wasatch Pediatrics Inc must report financial information, ownership details, and any other required information.
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