| NPI | 1386181931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADY HESS Administrator 801-644-5121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 5572357-4405) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |