| NPI | 1952716755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ISAACSON Owner 435-755-5799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: UT 1780691205) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |