| NPI | 1730691619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN C NYBERG Owner 435-429-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 93570531205) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2017-10-31 |