| NPI | 1740446160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN DAVID MCQUILKIN Owner 801-829-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 1761771205) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2008-08-05 |