| NPI | 1043673825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY PATRICK FOREST Officer 801-692-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 9567321-1202) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |