| NPI | 1043448798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS COLE SNYDER Owner/Registered Agent 435-882-1621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 6408046-1202) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2009-07-01 |