| NPI | 1013200351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON WARD CEO 801-356-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| 291U00000X Clinical Medical Laboratory (Licence: UT 46D1089668) | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2020-01-09 |