| NPI | 1295197614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRICE NEFF WILSON CEO 801-492-4892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-05-17 |