| NPI | 1245307842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAROHNDA JESTINE DENNISON Vice President 801-963-1880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 5415662) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: UT 5415662) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |