| NPI | 1710245402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GAHLINGER Billing Manager 801-484-5504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: UT 97-339160-1205) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2013-02-28 |