| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1194473520 | FOREVER YOUNG MEDICAL SERVICES PC | PO BOX 1385 | IDAHO FALLS | ID | 834031385 | |||
| 1457863912 | FORM SURGERY CENTER LLC | 6322 S 3000 E STE 170 | SALT LAKE CITY | UT | 841217290 | |||
| 1861923088 | IORIO | CAITLIN | 6322 S 3000 E STE 170 | SALT LAKE CITY | UT | 841217290 | ||
| 1609239763 | KHAYAT | SARAH | 196 W VINE ST APT A413 | SALT LAKE CITY | UT | 841075245 | ||
| 1053774455 | POWERS | BETHANY | R | 6322 S 3000 E STE 170 | SALT LAKE CITY | UT | 841217290 |