| NPI | 1831182799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY COX Administrator 435-656-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: UT 3020) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-01-16 |