| NPI | 1922174705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY ALLEN ANDREW Owner 435-259-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: UT 5160918-0144) |
| Enumeration Date | 2006-11-25 |
| Last Update Date | 2025-05-21 |