| NPI | 1184873960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A SNOW Manager 801-955-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: UT 114566-1202) |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: UT 114566-1202) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2009-04-01 |