| NPI | 1942681887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY DIANA DENTON Owner/Lpn 435-512-6152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: UT 94107620160) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |