| NPI | 1053586131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE FENTON Doctor/Director 801-627-2023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 6796488-1202) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |