| NPI | 1508862947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON A AHEE Medical Director 435-688-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: UT 62905) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2007-11-08 |