| NPI | 1780716563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI J LYONS Owner 801-387-4850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: UT 272784-1205) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2015-10-16 |