| NPI | 1235169921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY HONEY ALLRED Clinic Manager 801-253-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 5684661-1205) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-08-22 |