| NPI | 1770984379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD GARDEN Medical Director 801-579-7099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health (Licence: UT 9145099-1206) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |