| NPI | 1417066176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL RICHARD SWOBODA President 801-350-4479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 3560871205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 27746451205) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |