| NPI | 1356868319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED COLLETTE VP Of Finance 801-335-6455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2017-08-29 |