NPI | 1437488319 |
---|---|
Entity Type | Organization |
Authorized Contact | BRYAN ADAMS Owner 801-766-9822 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: UT 7526271-1204) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: UT 7526271-1204) |
207QA0000X Family Medicine, Adolescent Medicine (Licence: UT 7526271-1204) | |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2009-12-23 |
Last Update Date | 2010-08-26 |