| NPI | 1295855914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY D TWIGGS President 435-628-8034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: UT 88-178110-1205) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-25 |