| NPI | 1669662532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN R PETERSON Sole Proprietor 801-566-8304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 3139741205) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-07-27 |