| NPI | 1649523572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE JAY HADLEY Vice President 801-669-1607 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 201203834) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2013-05-30 |