| NPI | 1982642252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN A TERRY Medical Director 801-587-6307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 152W00000X Optometrist |
| 163W00000X Registered Nurse | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 208100000X Physical Medicine & Rehabilitation | |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2011-09-07 |