| NPI | 1932407277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BENNETT Owner 801-266-4212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 161245-1205) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2012-06-25 |