| NPI | 1619288370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTE J SCOTT Office Manager 801-589-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 162508-1202) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2010-06-28 |