| NPI | 1902286297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S NELSON Medical Director 801-501-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 6543672-8906) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-02 |