| NPI | 1316117344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANA KINIKINI MOUNGA President 801-521-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 20071866) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-03-05 |