NPI | 1023483252 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL BISHOP President 801-274-2500 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: UT 78978139922) |
Enumeration Date | 2015-12-14 |
Last Update Date | 2015-12-14 |