| NPI | 1134254063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE GREEN Business Manager 801-870-8985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 20061962) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-12-18 |