| NPI | 1750097135 |
|---|---|
| Former Legal Business Name | MY HOME MEDICAL |
| Entity Type | Organization |
| Authorized Contact | RYAN LARSEN Ap RN 801-540-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-01-27 |