| NPI | 1396926853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY G MILES President 801-966-6857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 3242701205) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2012-10-23 |