| NPI | 1710170709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE L CHRISTENSEN Assist Adm 801-225-0323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: UT 02) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2022-07-21 |