| NPI | 1396017661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI MARIE PRESTON Manager 801-369-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 4317) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2017-04-10 |