| 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 |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2024-06-03 |