| NPI | 1568996072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL OLSEN Owner 435-716-4103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 96939571205) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |