| NPI | 1982882940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BLAKE BIDDULPH Principle 801-434-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: UT 6880100-8007) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-02-01 |