| NPI | 1417008269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PAUL NEIDER RN, Director 801-641-8031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 6304541-3102) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |