| NPI | 1902311558 |
|---|---|
| Doing Business As | PNG UTAH |
| Entity Type | Organization |
| Authorized Contact | THEO S STEPHENS Chief Operations Officer 423-271-9911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2021-10-05 |