| NPI | 1497403646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA T TANDY Director 801-590-9267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2024-09-11 |