| NPI | 1336423201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN WESTENSKOW Vice Presdent Operations 801-312-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA 20A11023) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2011-10-10 |