| NPI | 1467812016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN PRITT Owner 801-991-0628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: UT 7493998-3501) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 7493998-3501) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2016-02-24 |