NPI | 1922279736 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY WANN Owner 801-523-3898 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: UT 5636714-1202) |
Enumeration Date | 2008-03-19 |
Last Update Date | 2008-03-19 |