| NPI | 1437383379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY DOUGLAS WYLIE Manager 801-380-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 187190-1205) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-06 |