| NPI | 1962463950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL ANDREWS Administrator 801-374-0354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: UT 2004-ASF-725) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2008-04-20 |