| NPI | 1205554367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANNETTE MIGNON BERENSEN CEO 801-507-8002 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2023-02-07 |