| NPI | 1932837135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE TOLMAN Office Manager/Medical Assistant 801-233-8670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2023-09-18 |