NPI | 1982449500 |
---|---|
Entity Type | Organization |
Authorized Contact | JEREMY ROBERT CHIDESTER Manager/Member 801-455-1914 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2024-06-26 |
Last Update Date | 2024-06-26 |