| NPI | 1619411774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI L PEARCE Owner/Manager 801-372-5899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 189082-4405) |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |