| NPI | 1447642988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCE LATSIS Director Of Client Services 801-441-1002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 70619161204) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2020-01-30 |