| 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 Service | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2021-06-16 |