| NPI | 1639347677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BRUCE TRAVELLER Owner 435-563-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: UT 6859851-1202) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-03-03 |