| NPI | 1528460482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN HAINSWORTH President 801-689-3389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: UT 9114228-1205) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: UT 6801881-1206) |
| 291U00000X Clinical Medical Laboratory (Licence: UT 46D2083659) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2016-03-18 |