| NPI | 1366559791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE S ARAGON Compliance Admin Asst/ Credentialin 801-260-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2024-03-28 |