| NPI | 1649425000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R. JAY SHETLIN Member 801-446-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: UT 374015-1202) |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2009-02-11 |