| NPI | 1932975257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL CRANDALL THOMAS President 801-718-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 104100000X Social Worker |
| 133V00000X Dietitian, Registered | |
| 163W00000X Registered Nurse | |
| 164W00000X Licensed Practical Nurse | |
| 164X00000X Licensed Vocational Nurse | |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| 183500000X Pharmacist | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2024-03-12 |