| NPI | 1477358356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PAGE WATT Owner, CEO 801-580-9690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2025-02-15 |
| Last Update Date | 2025-02-15 |