| NPI | 1871865188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN JOSE DELGADO Managing Owner 801-224-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 3085392-4405) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2020-09-25 |