| NPI | 1174707517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L WATSON Md / Owner 801-569-9133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 1756991205) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2008-10-01 |