| NPI | 1922400613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATE MILLER Owner 801-356-9958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: UT 7406925-1204) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: UT 6646778-1204) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |