| NPI | 1962733931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DAVID WESTOVER Clinical Director 801-373-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: UT 6615379-3501) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2010-01-14 |