| NPI | 1366017667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE LONG Owner 801-987-8786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |