| NPI | 1528231107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE A JULIEN Owner 801-718-8824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: UT 56180871205) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-20 |