| NPI | 1760753602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J CHRISTOPHER ROMNEY Owner 435-586-9904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: UT 167627-1202) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-02-23 |