| NPI | 1013426063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LARSEN President 801-849-8497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2024-09-25 |