| NPI | 1487331260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE WHITAKER Credentialing Specialist 801-965-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-03 |