| NPI | 1144246984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANI LASSITER Practice Administrator 801-572-3750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 188509-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 181268-1205) |
| 207Q00000X Family Medicine (Licence: UT 181191-8905) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-05-08 |