| NPI | 1831544618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J KIMBALL Owner 801-473-8848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 5206472) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |