| NPI | 1205208691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JOHN CIMIKOSKI Physician/Owner 801-651-1143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: UT 316586-1205) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |