| NPI | 1194076398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY D SCOTT Office Manager 801-647-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-12-10 |