| NPI | 1093697468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL ANN FRAGA Director Of Payer Development 801-921-6325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2025-10-08 |