| NPI | 1821417684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES E WELLMAN President 801-476-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: UT 164703-1205) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |