| NPI | 1508162736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA CHAMBERLAIN Nurse Practitioner 801-809-2119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 4779643-4405) |
| Enumeration Date | 2011-02-05 |
| Last Update Date | 2011-02-05 |