| NPI | 1518256650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK N GREEN Owner 801-828-5857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2024-06-13 |