NPI | 1649440108 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD CALVIN JONES Owner 801-373-1275 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: UT 170264-1205) |
Enumeration Date | 2008-03-11 |
Last Update Date | 2008-03-11 |