| NPI | 1699197749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MASTERS Regional Recruiter 801-495-5279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: WA OT60424838) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |