| NPI | 1184149361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA K CARTER Prescriber/Owner 435-299-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: UT 10410631-0142) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2021-08-24 |