| NPI | 1124079843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BERG Administrator 801-383-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 2006-31532) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2009-10-28 |