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 |