| NPI | 1245833235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY LEANY Owner 435-669-0984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2020-11-20 |