| NPI | 1235553850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK C GREENWOOD Owner 801-554-8662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: UT 6942268-1205) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-02-18 |