NPI | 1376944942 |
---|---|
Entity Type | Organization |
Authorized Contact | JARED REX HEATON Physician 435-770-9247 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: UT 9017921-1204) |
Enumeration Date | 2014-09-14 |
Last Update Date | 2014-09-14 |