| NPI | 1689824252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY JOHNSON Owner 435-225-3462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: UT 2008-HHA-86908) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2008-09-19 |