| NPI | 1013028505 |
|---|---|
| Doing Business As | SPORTS MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHRIS HOLMGREN DAHLBERG Corporation President, Business Own 801-621-8835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 115411-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 114380-2401) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: UT 115411-2401) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: UT 114380-2401) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-04-17 |