| NPI | 1194013870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAVIN N VAN STADEN Owner 801-296-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: UT 5863514-1205) |
| Additional Taxonomies | 261Q00000X (Licence: UT 284903-1205) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2011-07-15 |