| NPI | 1386304525 |
|---|---|
| Doing Business As | PHIL LONG ONSITE CLINIC |
| Entity Type | Organization |
| Authorized Contact | DARCE LATSIS Director Of Operations 801-441-1002 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2021-12-29 |