| NPI | 1457076903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY PAVICK Sr. Operations Manager 435-274-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2024-04-02 |