| NPI | 1316172596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY E DILLMAN Owner 801-944-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: UT 1395529922) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |