| NPI | 1366252769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSON CATMULL Owner 801-694-1743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2025-01-09 |
| Last Update Date | 2025-01-20 |