| NPI | 1063781813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD FULLMER Vice President 801-494-0486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |