| NPI | 1851540520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DOUGLAS TAYLOR Member 435-671-4726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: UT 6672822-0501) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2009-06-24 |