| NPI | 1669452298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE EDWIN PEHRSON President 435-722-7704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: UT v09531) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207QA0505X Family Medicine, Adult Medicine (Licence: UT v09531) | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2020-08-22 |