| NPI | 1821321597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS CROCKETT Executive Administrator 801-465-4899 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 7376450-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 184332-1205) |
| 207Q00000X Family Medicine (Licence: UT 175869-1205) | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-11-19 |