| NPI | 1487261707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE BYERS Manager 801-910-4498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 261QP3300X Clinic/Center, Pain | |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-10-06 |