| NPI | 1699115188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN C OBAH Owner 801-786-9030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: UT 5867369-1205) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: UT 5867389-1205) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2013-09-03 |