| NPI | 1699977496 |
|---|---|
| Other Name | PROVO OFFICE |
| Entity Type | Organization |
| Authorized Contact | ADAM B. RASMUSSEN COO 801-374-1801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 358469-8905) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2011-02-17 |