| NPI | 1033667415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN WILSON CEO 801-717-8487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2024-01-31 |