| NPI | 1821376161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LEE CHILD President 801-766-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 7112893-1204) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2011-08-03 |