| NPI | 1275021784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNELYN SANCHEZ Business Director 801-347-5374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 9806097) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2025-08-21 |