| NPI | 1104561224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT D HOFHINES Managing Member 435-229-3245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-07-26 |