| NPI | 1477646479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDELL A GIBBY Owner 801-437-4895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 5414031-1704) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2011-10-27 |