| NPI | 1164613790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE M MONROE Director/Surgeon 801-224-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 2619191205) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2022-10-05 |