| NPI | 1609385509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER REX THORNOCK Manager 435-668-4334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 604089025) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2018-03-17 |