| NPI | 1174073837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARBOD MISAGHIAN Owner 801-884-9687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-10-06 |