| NPI | 1740461656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SCOTT PETERSON Owner 801-281-1788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2020-10-27 |