| NPI | 1295155224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY J MACKELPRANG President 801-870-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: UT 72-154020-1205) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-09-29 |