| NPI | 1144413899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY F KIRK Owner 435-674-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 1932229259) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2008-08-28 |