| NPI | 1407414980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA LYNN MIRACLE Midwife 801-923-8806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QB0400X Clinic/Center Birthing |
| Additional Taxonomies | 176B00000X Midwife |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |