NPI | 1184843278 |
---|---|
Entity Type | Organization |
Authorized Contact | DARREN CLUFF Practice Administrator 801-268-3800 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: UT 1036039-0144) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2020-08-22 |