| NPI | 1003060906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER L LARSON President/Owner 801-266-7534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 105692-2401) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2009-02-05 |