| NPI | 1265656227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT D KENNEDY Director 801-261-3637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 2001ASF0602) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |