| NPI | 1104122720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R FLETCHER President 801-641-3686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: UT 7545378-1202) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-01-28 |