| NPI | 1053715250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER GUYMON Credentialing Specialist 801-769-2571 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2024-03-22 |