| NPI | 1144467424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN RICHARD CHRISTENSEN Doctor 801-657-0061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: UT 7044278-9934) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-02-04 |