| NPI | 1639793367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK L PHILLIPS President 435-862-6143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |