| NPI | 1639385438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH W VICKROY President 801-293-6823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: UT 183895-1205) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2024-08-05 |