NPI | 1043375181 |
---|---|
Entity Type | Organization |
Authorized Contact | LAYNE A HERMANSEN Owner 801-542-7111 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2006-12-27 |
Last Update Date | 2020-08-22 |