| NPI | 1487446324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJ YERGENSEN Admin 435-986-9369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 174400000X Specialist |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-19 |