| NPI | 1780314724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS BOWLES Nurse Practitioner 435-610-9197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |