| NPI | 1639141252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE RICHARDS Office Manager 801-268-0306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 952959151205) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2020-08-22 |