| NPI | 1093123945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER CHENEY Director 801-336-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: UT 5309691-1202) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2016-04-15 |