| NPI | 1265211221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY WALKER Owner 435-200-9965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2025-09-10 |