NPI | 1417118498 |
---|---|
Entity Type | Organization |
Authorized Contact | KRIS I. DAVIS Director 801-475-1800 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: UT 3376391202) |
Enumeration Date | 2008-06-23 |
Last Update Date | 2008-06-23 |