| NPI | 1639200215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN K ANDERSON Sole Owner 801-292-4425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery |
| 291U00000X Clinical Medical Laboratory | |
| 247100000X Radiologic Technologist | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2025-11-04 |