| NPI | 1841055092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENTON COLLINS Mso 801-712-2075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-10-22 |