| NPI | 1558398800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN K. RUGG Administrator 801-278-3102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 5019451-0142) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-08-22 |