| NPI | 1710606975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISE M MECHAM Managing Member 801-756-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2023-05-16 |