| NPI | 1255533238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA C. MAW Nurse Practitioner 801-361-6038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 213838-4405) |
| Enumeration Date | 2007-06-02 |
| Last Update Date | 2020-08-22 |