NPI | 1447267554 |
---|---|
Entity Type | Organization |
Authorized Contact | CHAD W ANDERSON Medical Director 435-586-3402 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT Exempt) |
Enumeration Date | 2006-08-02 |
Last Update Date | 2014-03-26 |