NPI | 1770060980 |
---|---|
Entity Type | Organization |
Authorized Contact | MARIA G CRUZ Owner/Provider 801-560-0930 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207N00000X Dermatology |
207V00000X Obstetrics & Gynecology | |
261QH0100X Clinic/Center, Health Services | |
Enumeration Date | 2018-07-20 |
Last Update Date | 2021-06-16 |