| NPI | 1467708750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BRIAN CAPEL Therapist 801-641-8569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: UT 2624423501) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2012-07-24 |