| NPI | 1508655184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENAE O'RIELLEY Interim Office Manager 801-903-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-05-01 |