| NPI | 1972510717 |
|---|---|
| Former Legal Business Name | FKA MOUNTAIN WEST GASTROENTEROLOGY, P.C. |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MORRIS Corporate Administrator 801-944-3191 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2021-07-22 |