| NPI | 1659931384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER CARK Owner 801-822-1880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 207Q00000X Family Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208D00000X General Practice | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2021-04-29 |