NPI | 1295876639 |
---|---|
Entity Type | Organization |
Authorized Contact | VERNON D. POTTER Managing Member 801-576-8988 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 2939081205) |
Enumeration Date | 2007-02-09 |
Last Update Date | 2012-08-31 |