| NPI | 1194815639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PARRY Administrator 435-586-5131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 2017-ASF-62751) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-12-06 |