| NPI | 1124747563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GIBBS Owner 435-615-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 213E00000X Podiatrist | |
| Enumeration Date | 2022-08-26 |
| Last Update Date | 2022-08-26 |