| NPI | 1083067409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT NOORDA CEO 435-688-2292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 9705544-1204) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: UT 7443716-1202) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |