| NPI | 1083897185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF WARE Billing Manager 801-581-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 5034170-4405) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2007-12-11 |