| 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 |