| NPI | 1760789374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN SMITH Member 801-688-3693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: UT 7845949-1202) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-02-16 |