| NPI | 1255692075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT NEPHI WALL President 801-798-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 5129809-4405) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2012-06-07 |