| NPI | 1578869020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSI JENKINS Billing Manager 801-475-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 5285165-1204) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: UT 5285165-1204) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-03-22 |