| NPI | 1184807992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE RICHARD BEAZER Medical Doctor 435-882-2358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 52480801205) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2014-01-10 |