| NPI | 1972759371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LEVINE Owner / Md 801-569-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 33292020-1205) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2018-06-21 |