NPI | 1174247811 |
---|---|
Entity Type | Organization |
Authorized Contact | MARIANA HANKINS Medical Director 801-888-1140 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2022-09-27 |
Last Update Date | 2024-11-06 |