| NPI | 1528207727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC DAVID LAPIN Owner 801-424-2849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: UT 52529) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-02-11 |