| NPI | 1487529764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN FOGG Physician 801-712-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |