| NPI | 1255502050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JEFFERY WILLIAMS Owner 801-313-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 5322538-1205) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2019-09-16 |