| NPI | 1922192913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA D RUST Owner Of Business 435-789-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: UT 18896-4405) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2017-12-13 |