| NPI | 1861837924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN WATKINS Billing Manager 801-473-7035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: UT 1706651205) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2013-05-02 |