| NPI | 1649555046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIS C BRADSHAW President 435-613-2229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 80664271205) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-10-17 |