| NPI | 1952580326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA ELAYNE DIERSING CLAPP President And Sole Shareholder 801-495-9303 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 49308814405) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |